Claim total
$1,361.07
base $127.17 · payer covered $1,311.07
The visit
- Class
- Inpatient
- Code
- 32485007
- Start
- 1971-06-23
- Stop
- 1971-06-24
The parties
- Patient
- patient Lonnie Schroeder
- Provider
- provider Tiffany Sauer
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
30ee6aa0-fa33-9d82-0280-a2109d7bd5da