Claim total
$4,283.47
base $127.17 · payer covered $4,248.47
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 1993-10-06
- Stop
- 1993-10-08
The parties
- Patient
- patient Roselyn Aleen Fay
- Provider
- provider Melba Langosh
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Dual Eligible
Record id
2372de44-5560-bbe7-2c49-a3374029847e