Claim total
$4,339.75
base $127.17 · payer covered $3,471.75
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2002-06-22
- Stop
- 2002-06-24
The parties
- Patient
- patient Max Don Farrell
- Provider
- provider Melba Langosh
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicare
Record id
255c6642-35d4-c675-cf3d-d7023ce242db