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
- 1981-04-03
- Stop
- 1981-04-13
The parties
- Patient
- patient Arthur Pablo Greenfelder
- Provider
- provider Ellsworth Marquardt
- Payer
- payer Dual Eligible
Record id
028512d5-49bb-87e7-5c96-7e5efada11b3