Acct #

Total Charges

Current Balance

23395476

$6,837.00

$6,837.00

Sharon L Anderson
697 SURREY AVE
Saint Paul, Minnesota 55106

Thank you for choosing HealthEast Care System for your healthcare needs. This is an itemized statement for Sharon L
Anderson's visit on 04/16/2015 at St. Joseph's Hospital which reflects total charges of $6,837.00. The current balance as
of 4/22/2015 for the visit is $6,837.00.
Call (651) 232-1100
Customer service representatives are available
8:00 AM to 4:30 PM (except holidays).

Questions?

Coverage(s) on file
UCARE - UCARE FOR SENIORS

Hospital Charges
Date

Rev Code

Procedure
Code
34300006
34300001
34100026
48200001

Description

04/16/15
0343
TL-201 (PER MCI)
04/16/15
0343
SESTAMIBI (PER DOSE)
04/16/15
0341
MYOCARDIAL SPECT MULTIPLE STUDIES
04/16/15
0482
CARDIAC STRESS TST,TRACING ONLY
Total hospital charges:
Total hospital payments and adjustments:

For financial or billing questions please call: 651-232-1100 or 1-866-770-6411

www.healtheast.org

Qty

Amount

4
1
1
1

360.00
279.00
5,122.00
1,076.00
6,837.00
0.00