Claim total
$17,987.34
base $127.17 · payer covered $17,952.34
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 1992-09-27
- Stop
- 1992-10-11
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-bbe7-0025-be11ff4f1863