Claim total
$14,380.50
base $127.17 · payer covered $10,066.62
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2016-06-17
- Stop
- 2016-06-28
The parties
- Patient
- patient Adolph Winford Hyatt
- Provider
- provider Elvis Lebsack
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Cigna Health
Record id
1da1ccef-4f88-f506-14d0-81dc5998402d