Claim total
$3,368.92
base $127.17 · payer covered $2,695.12
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2026-03-09
- Stop
- 2026-03-10
The parties
- Patient
- patient Boyce Jerrold Johns
- Provider
- provider Lilia Montañez
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
18cbb615-420a-8641-8d74-511023ac0f6f