Claim total
$23,991.54
base $93.39 · payer covered $19,193.23
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Ischemic heart disease414545008
- Start
- 2015-12-17
- Stop
- 2015-12-17
The parties
- Patient
- patient Simon Frederic Gulgowski
- Provider
- provider Vicente Kilback
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
034c4f48-8c73-4f35-9afc-7ac182df1fdc