Claim total
$3,830.42
base $127.17 · payer covered $3,064.29
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2011-11-26
- Stop
- 2011-11-28
The parties
- Patient
- patient Hugo Lucas Valenzuela
- Provider
- provider Elvis Lebsack
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicare
Record id
335171b1-99b5-a5ab-5aba-584bc33ca7a5