Claim total
$2,794.94
base $127.17 · payer covered $2,235.93
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2022-05-28
- Stop
- 2022-05-30
The parties
- Patient
- patient Domenic Brock Dach
- Provider
- provider Viva Heathcote
- Payer
- payer Medicare
Record id
19137cbd-9649-bf65-5d23-3d132ec01b58