Claim total
$127.17
base $127.17 · payer covered $101.74
The visit
- Class
- Inpatient
- Code
- 56876005
- Reason
- diagnosis concept Dependent drug abuse6525002
- Start
- 2025-04-29
- Stop
- 2025-05-12
The parties
- Patient
- patient Harland Carmine Herzog
- Provider
- provider Melanie Gibson
- Care site
- care site Brooklyn Park Vet Center
- Payer
- payer Medicare
Record id
0302711f-bc3a-898e-b482-ea12064258e1