Claim total
$901.03
base $93.39 · payer covered $866.03
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 1990-09-29
- Stop
- 1990-09-29
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-e968-d2cf433bd46d