Claim total
$3,424.06
base $127.17 · payer covered $2,739.21
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2001-07-05
- Stop
- 2001-07-07
The parties
- Patient
- patient Jami Helen Wisoky
- Provider
- provider Tiffany Sauer
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
24dd8ac8-6bcb-597c-4427-6e803076d973