Claim total
$15,133.88
base $127.17 · payer covered $12,107.08
The visit
- Class
- Inpatient
- Code
- 397821002
- Reason
- diagnosis concept History of aortic valve replacement1231000119100
- Start
- 1988-12-23
- Stop
- 1988-12-24
The parties
- Patient
- patient Princess Felisha Kub
- Provider
- provider Tiffany Sauer
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
2918896c-6cc7-6a93-d691-43dbb81180fe