Claim total
$5,052.16
base $116.56 · payer covered $3,855.33
The visit
- Class
- Hospice
- Code
- 305336008
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2024-11-15
- Stop
- 2024-11-22
The parties
- Patient
- patient Jewel Chi Harris
- Provider
- provider Georgene Bergnaum
- Care site
- care site GROUP HEALTH PLAN INC
- Payer
- payer Medicare
Record id
05c57aa9-c3e8-2f04-9af3-8b6f33e0b157