Claim total
$1,905.72
base $93.39 · payer covered $1,870.72
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 1996-11-04
- Stop
- 1996-11-04
The parties
- Patient
- patient Brian Waldo Hettinger
- Provider
- provider Maragaret Harber
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Dual Eligible
Record id
1f852fca-7569-a697-b420-d12cc5e48d6f