Claim total
$851.54
base $93.39 · payer covered $801.54
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2017-12-20
- Stop
- 2017-12-20
The parties
- Patient
- patient Lynn Catrina Keebler
- Provider
- provider Tiffany Sauer
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
1ce83e5f-4669-f644-1473-54234d60982e