Claim total
$1,309.38
base $93.39 · payer covered $1,274.38
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 1988-11-04
- Stop
- 1988-11-04
The parties
- Patient
- patient Heike Nelida Olson
- Provider
- provider Tiffany Sauer
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
195810b4-1136-614f-20a1-021d0466d2fd