Claim total
$5,577.51
base $127.17 · payer covered $5,542.51
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2020-10-22
- Stop
- 2020-10-25
The parties
- Patient
- patient Terrell Allan Walter
- Provider
- provider Vicente Kilback
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
0c1ee120-1dc7-6b68-ac35-b91b31af8446