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- The document is a hospital bill for a patient named Mrs. Pratiksha Rautaray who was admitted on November 24, 2018 and discharged on November 25, 2018.
- The bill includes charges for various medical services provided like consultations, investigations, procedures, surgery, anesthesia, nursing care, pharmacy items, and consumables totaling Rs. 55,847.21.
- After a hospital discount of Rs. 5,167 and authorized insurance amount of Rs. 44,580, the patient's copay amount is Rs. 5,000 plus non-medical expenses of Rs. 1,100, bringing the total balance due to Rs. 6,100.
- The document is a hospital bill for a patient named Mrs. Pratiksha Rautaray who was admitted on November 24, 2018 and discharged on November 25, 2018.
- The bill includes charges for various medical services provided like consultations, investigations, procedures, surgery, anesthesia, nursing care, pharmacy items, and consumables totaling Rs. 55,847.21.
- After a hospital discount of Rs. 5,167 and authorized insurance amount of Rs. 44,580, the patient's copay amount is Rs. 5,000 plus non-medical expenses of Rs. 1,100, bringing the total balance due to Rs. 6,100.
- The document is a hospital bill for a patient named Mrs. Pratiksha Rautaray who was admitted on November 24, 2018 and discharged on November 25, 2018.
- The bill includes charges for various medical services provided like consultations, investigations, procedures, surgery, anesthesia, nursing care, pharmacy items, and consumables totaling Rs. 55,847.21.
- After a hospital discount of Rs. 5,167 and authorized insurance amount of Rs. 44,580, the patient's copay amount is Rs. 5,000 plus non-medical expenses of Rs. 1,100, bringing the total balance due to Rs. 6,100.
ServiceTax Reg No : AACCS9646MSD005 Bill No. : ICR54573
Insurance Company : BAJAJ ALLIANZ INSURANCE Bill DateTime : 11/25/2018 11:23 TPA Name : MEDI-ASSIST INDIA PVT LTD UHID : SAH1.0000624722 Corp Name : ATTRA INFOTECH PVT LTD Age / Sex : 33 Year(s)/ Female IP NO. : IPID.0161022 Bed : SPT311A Patient Name : MRS PR AN AT I RAUTARAY Ward : NURSING STN 3RD FLR Address : #49/50 Admit Date : 11/24/2018 10:08 , J P NAGAR V TH PHASE Discharge Date : 11/25/2018 11:22 BENGALURU,KARNATAKA Doctor Name : Dr SUBHASH RC