Claim total
$5,935.23
base $127.17 · payer covered $4,748.12
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2011-10-25
- Stop
- 2011-10-28
The parties
- Patient
- patient Hugo Lucas Valenzuela
- Provider
- provider Elvis Lebsack
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicare
Record id
335171b1-99b5-a5ab-fb2a-eb0928761257