Claim total
$17,111.36
base $155.66 · payer covered $17,061.36
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2017-11-01
- Stop
- 2017-11-01
The parties
- Patient
- patient Mandy Christie Stracke
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00aca497-ef30-85f4-18b7-d99a75815486