Claim total
$10,529.77
base $127.17 · payer covered $10,494.77
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2024-11-22
- Stop
- 2024-11-29
The parties
- Patient
- patient Adina Jerlene Baumbach
- Provider
- provider Jeromy Adams
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
13decf1b-6d14-8aef-961e-950b6a75a1c5