Claim total
$13,649.09
base $127.17 · payer covered $13,614.09
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 1992-03-22
- Stop
- 1992-03-31
The parties
- Patient
- patient Roselyn Aleen Fay
- Provider
- provider Maragaret Harber
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Dual Eligible
Record id
2372de44-5560-bbe7-7b98-b3fc37606dab