Claim total
$5,606.61
base $127.17 · payer covered $5,571.61
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2008-09-05
- Stop
- 2008-09-07
The parties
- Patient
- patient Belva Sau Barrows
- Provider
- provider Tiffany Sauer
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
1625e802-c261-3bac-7c4a-23bef0e6d4ad