Claim total
$3,392.83
base $127.17 · payer covered $3,342.83
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept History of aortic valve replacement1231000119100
- Start
- 2025-02-13
- Stop
- 2025-02-20
The parties
- Patient
- patient Xuan Clyde Glover
- Provider
- provider Melba Langosh
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
126205ae-f6d6-030f-1a2f-c9a2e87bbe5a