Claim total
$4,756.84
base $127.17 · payer covered $3,805.40
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2014-10-14
- Stop
- 2014-10-17
The parties
- Patient
- patient Agnes Dietrich
- Provider
- provider Madison Cartwright
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
270ef1b8-bd71-e9bb-18e4-9e79dbd6f1cd