Claim total
$4,762.26
base $127.17 · payer covered $3,809.74
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2023-11-21
- Stop
- 2023-11-24
The parties
- Patient
- patient Domenic Brock Dach
- Provider
- provider Viva Heathcote
- Payer
- payer Medicare
Record id
19137cbd-9649-bf65-e5c5-75318d6251fe