Claim total
$13,775.63
base $127.17 · payer covered $13,725.63
The visit
- Class
- Inpatient
- Code
- 32485007
- Start
- 2000-08-24
- Stop
- 2000-08-26
The parties
- Patient
- patient Ted Claude O'Conner
- Provider
- provider Tiffany Sauer
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
2ef29fe0-cf19-e6ae-5b8f-cf8775811b27