Claim total
$3,784.60
base $127.17 · payer covered $3,027.66
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2001-06-16
- Stop
- 2001-06-17
The parties
- Patient
- patient Max Don Farrell
- Provider
- provider Melba Langosh
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicare
Record id
255c6642-35d4-c675-bfd7-ea066ce05ee3