Claim total
$1,934.68
base $93.39 · payer covered $1,547.73
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 1999-12-23
- Stop
- 1999-12-23
The parties
- Patient
- patient Jami Helen Wisoky
- Provider
- provider Tiffany Sauer
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
24dd8ac8-6bcb-597c-7a3a-d0658b953cb3