Claim total
$728.31
base $127.17 · payer covered $678.31
The visit
- Class
- Inpatient
- Code
- 305342007
- Reason
- diagnosis concept History of aortic valve replacement1231000119100
- Start
- 2025-02-20
- Stop
- 2025-02-21
The parties
- Patient
- patient Xuan Clyde Glover
- Provider
- provider Maragaret Harber
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
126205ae-f6d6-030f-41e6-c3e112d32f30