Claim total
$4,801.40
base $127.17 · payer covered $4,766.40
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 1992-03-10
- Stop
- 1992-03-11
The parties
- Patient
- patient Susanna Avis Emard
- Provider
- provider Melba Langosh
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Dual Eligible
Record id
0443166c-c803-503e-ad55-19d267ec7ff4