Claim total
$5,290.88
base $155.66 · payer covered $5,290.88
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-01-06
- Stop
- 2025-01-06
The parties
- Patient
- patient Onie Shannon Borer
- Provider
- provider Daryl Farrell
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Aetna
Record id
006af299-d813-2b4f-ffe9-42445ebe699d