Claim total
$2,794.72
base $127.17 · payer covered $2,235.76
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2018-04-12
- Stop
- 2018-04-13
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-e0ad-0717fe1e3cd8