Claim total
$1,226.62
base $93.39 · payer covered $1,191.62
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2007-03-15
- Stop
- 2007-03-15
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-d278-d2c30755d1a0