Claim total
$6,697.56
base $127.17 · payer covered $6,662.56
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 1989-05-03
- Stop
- 1989-05-06
The parties
- Patient
- patient Heike Nelida Olson
- Provider
- provider Tiffany Sauer
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
195810b4-1136-614f-c57f-48a9b46f9d4f