Claim total
$125.00
base $125.00 · payer covered $90.00
The visit
- Class
- Virtual
- Code
- 448337001
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2025-12-28
- Stop
- 2025-12-28
The parties
- Patient
- patient Jewel Chi Harris
- Provider
- provider Madison Cartwright
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
05c57aa9-c3e8-2f04-0b02-d8d32329ee8e