Claim total
$13,112.81
base $155.66 · payer covered $13,062.81
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-03-05
- Stop
- 2025-03-05
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-ce76-c4f9a15c4632