Claim total
$11,980.01
base $127.17 · payer covered $9,583.80
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2001-04-30
- Stop
- 2001-05-09
The parties
- Patient
- patient Mireya Bode
- Provider
- provider Lilia Montañez
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
04f53306-ad14-544b-91f9-09df263dde80