Claim total
$1,269.69
base $93.39 · payer covered $1,219.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 1992-09-07
- Stop
- 1992-09-08
The parties
- Patient
- patient Susanna Avis Emard
- Provider
- provider Melba Langosh
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
0443166c-c803-503e-3d3c-b10040fcffd8