Claim total
$5,049.65
base $127.17 · payer covered $4,039.66
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2018-03-27
- Stop
- 2018-03-30
The parties
- Patient
- patient Gaylene Adell Reynolds
- Provider
- provider Melba Langosh
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicare
Record id
34c15c13-e4f6-1b19-29e5-9b56255b4e65