Claim total
$19,920.45
base $127.17 · payer covered $15,936.03
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2014-12-11
- Stop
- 2014-12-25
The parties
- Patient
- patient Adolph Winford Hyatt
- Provider
- provider Elvis Lebsack
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicare
Record id
1da1ccef-4f88-f506-db31-1335e52d48f2