Claim total
$4,034.03
base $127.17 · payer covered $3,999.03
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2026-02-20
- Stop
- 2026-02-22
The parties
- Patient
- patient Adina Jerlene Baumbach
- Provider
- provider Jeromy Adams
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
13decf1b-6d14-8aef-40c4-26d12fd4efaf