Claim total
$5,692.63
base $127.17 · payer covered $4,554.01
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2018-03-18
- Stop
- 2018-03-22
The parties
- Patient
- patient Jordan Darrel Hodkiewicz
- Provider
- provider Vicente Kilback
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
26a1fd64-1e1f-4fc3-a04e-4bee7f49759c