Claim total
$1,139.61
base $127.17 · payer covered $1,104.61
The visit
- Class
- Inpatient
- Code
- 305342007
- Reason
- diagnosis concept History of aortic valve replacement1231000119100
- Start
- 2000-12-18
- Stop
- 2000-12-19
The parties
- Patient
- patient Bob Sergio O'Hara
- Provider
- provider Vicente Kilback
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
261c034c-cc44-5f0f-545f-b283e842db97