Claim total
$1,388.98
base $93.39 · payer covered $1,338.98
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Ischemic heart disease414545008
- Start
- 2006-08-29
- Stop
- 2006-08-29
The parties
- Patient
- patient Lamar Mark Connelly
- Provider
- provider Tiffany Sauer
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
050746ba-be7e-c592-39db-51709fa3030d