Claim total
$4,890.53
base $127.17 · payer covered $3,912.38
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 1997-06-28
- Stop
- 1997-06-30
The parties
- Patient
- patient Maybelle Pansy Buckridge
- Provider
- provider Madison Cartwright
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
2db4e680-0037-4778-9633-162604932c40