Claim total
$4,959.30
base $127.17 · payer covered $3,967.37
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2026-02-09
- Stop
- 2026-02-12
The parties
- Patient
- patient Lisabeth Eleonora Jacobs
- Provider
- provider Elvis Lebsack
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicare
Record id
1e25f1c3-be93-eaea-98ff-9383d78169cb