Claim total
$5,917.07
base $127.17 · payer covered $4,733.58
The visit
- Class
- Inpatient
- Code
- 305432006
- Reason
- diagnosis concept Awaiting transplantation of kidney698306007
- Start
- 2021-07-23
- Stop
- 2021-08-01
The parties
- Patient
- patient Sheldon Milan Koch
- Provider
- provider Charlie Tillman
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Anthem
Record id
28fc4489-6f3e-4157-68a0-8111a1456132