Claim total
$12,943.33
base $127.17 · payer covered $10,354.43
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2017-09-02
- Stop
- 2017-09-12
The parties
- Patient
- patient Kallie Lynna Hagenes
- Provider
- provider Vicente Kilback
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
0a242b14-0437-1a7e-9101-e92416c83adf