Claim total
$2,687.75
base $93.39 · payer covered $2,637.75
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2010-09-25
- Stop
- 2010-09-25
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-6d35-975d-a6c4d0f7a6f9