Claim total
$2,152.05
base $127.17 · payer covered $2,117.05
The visit
- Class
- Inpatient
- Code
- 305432006
- Reason
- diagnosis concept Awaiting transplantation of kidney698306007
- Start
- 2021-04-24
- Stop
- 2021-04-26
The parties
- Patient
- patient Mariana Ana Ornelas
- Provider
- provider Saundra Heller
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
11444f3f-edac-88ba-91a9-fad717d50441