Claim total
$1,555.37
base $93.39 · payer covered $1,505.37
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2022-01-25
- Stop
- 2022-01-25
The parties
- Patient
- patient Annamarie Gretta Wolff
- Provider
- provider Vicente Kilback
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
109b1845-597b-4626-aef3-c8895586d283