Claim total
$24,510.06
base $127.17 · payer covered $24,460.06
The visit
- Class
- Inpatient
- Code
- 305351004
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2011-03-24
- Stop
- 2011-04-12
The parties
- Patient
- patient Scott Emelina Fisher
- Provider
- provider Tiffany Sauer
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
3876b3a4-351a-6d35-0ca7-8e7ebdab743a