Claim total
$10,937.21
base $155.66 · payer covered $10,887.21
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-05-02
- Stop
- 2018-05-02
The parties
- Patient
- patient Mandy Christie Stracke
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00aca497-ef30-85f4-aab9-5ac9f2f9f687