Claim total
$3,240.53
base $127.17 · payer covered $2,592.40
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2018-12-29
- Stop
- 2018-12-30
The parties
- Patient
- patient Mitchell Buck Williamson
- Provider
- provider Tiffany Sauer
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
30e5ea2d-b852-2bba-4bf4-1708c32226f5