Claim total
$13,463.07
base $127.17 · payer covered $13,428.07
The visit
- Class
- Inpatient
- Code
- 305411003
- Reason
- diagnosis concept Chronic obstructive bronchitis185086009
- Start
- 1980-06-06
- Stop
- 1980-06-25
The parties
- Patient
- patient Arthur Pablo Greenfelder
- Provider
- provider Albertha Gaylord
- Payer
- payer Dual Eligible
Record id
028512d5-49bb-87e7-c135-bf3f9922535a