Claim total
$13,607.79
base $127.17 · payer covered $10,886.21
The visit
- Class
- Inpatient
- Code
- 397821002
- Reason
- diagnosis concept History of aortic valve replacement1231000119100
- Start
- 2013-10-18
- Stop
- 2013-10-19
The parties
- Patient
- patient Bonita Lehner
- Provider
- provider Tiffany Sauer
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
0955adaa-a76f-8e05-c945-d03293997c03