Claim total
$2,603.95
base $93.39 · payer covered $2,568.95
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2024-05-26
- Stop
- 2024-05-26
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-e744-92fadffa5469