Claim total
$3,522.99
base $127.17 · payer covered $2,818.35
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2024-06-13
- Stop
- 2024-06-15
The parties
- Patient
- patient Domenic Brock Dach
- Provider
- provider Viva Heathcote
- Payer
- payer Medicare
Record id
19137cbd-9649-bf65-a22e-fe0704322e58