Claim total
$2,712.27
base $127.17 · payer covered $2,677.27
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2017-04-06
- Stop
- 2017-04-07
The parties
- Patient
- patient Quintin Loyd Ullrich
- Provider
- provider Elvis Lebsack
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Dual Eligible
Record id
33a68753-f79f-bb9d-4eba-c151f3c49e2b