Claim total
$2,119.63
base $93.39 · payer covered $2,084.63
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2022-08-18
- Stop
- 2022-08-18
The parties
- Patient
- patient Jewel Chi Harris
- Provider
- provider Vicente Kilback
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
05c57aa9-c3e8-2f04-3c10-04d461f7149e