Claim total
$3,817.38
base $127.17 · payer covered $3,053.88
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2025-08-02
- Stop
- 2025-08-03
The parties
- Patient
- patient Jewel Chi Harris
- Provider
- provider Vicente Kilback
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
05c57aa9-c3e8-2f04-9b5d-7acb7a6e404e