Claim total
$1,139.61
base $127.17 · payer covered $911.68
The visit
- Class
- Inpatient
- Code
- 305342007
- Reason
- diagnosis concept History of aortic valve replacement1231000119100
- Start
- 2012-10-29
- Stop
- 2012-10-30
The parties
- Patient
- patient Demetra Katheryn Wisoky
- Provider
- provider Melba Langosh
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicare
Record id
08fe74ff-5d25-add3-4082-a4759dfc7725