Claim total
$16,109.56
base $127.17 · payer covered $16,059.56
The visit
- Class
- Inpatient
- Code
- 32485007
- Start
- 2006-09-04
- Stop
- 2006-09-05
The parties
- Patient
- patient Lamar Mark Connelly
- Provider
- provider Tiffany Sauer
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
050746ba-be7e-c592-51d1-18256e6964cc