Claim total
$9,212.40
base $155.66 · payer covered $9,212.40
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2016-12-11
- Stop
- 2016-12-11
The parties
- Patient
- patient Xuan Collier
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
002d4429-df26-5797-c213-0e9d153c29b2