Claim total
$5,052.16
base $116.56 · payer covered $5,017.16
The visit
- Class
- Hospice
- Code
- 305336008
- Reason
- diagnosis concept Chronic obstructive bronchitis185086009
- Start
- 2000-06-06
- Stop
- 2000-06-14
The parties
- Provider
- provider Georgene Bergnaum
- Care site
- care site GROUP HEALTH PLAN INC
- Payer
- payer Dual Eligible
Record id
0126321a-a5af-784d-06a4-e59306fcda4b