Claim total
$728.31
base $127.17 · payer covered $678.31
The visit
- Class
- Inpatient
- Code
- 305342007
- Reason
- diagnosis concept History of aortic valve replacement1231000119100
- Start
- 1976-09-17
- Stop
- 1976-09-18
The parties
- Patient
- patient Belva Sau Barrows
- Provider
- provider Tiffany Sauer
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
1625e802-c261-3bac-b403-c62127a9c0b6