Claim total
$1,800.28
base $93.39 · payer covered $1,750.28
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Ischemic heart disease414545008
- Start
- 2003-04-12
- Stop
- 2003-04-12
The parties
- Provider
- provider Vicente Kilback
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
04481159-34f8-6925-8e26-3ee7391c25d3