Claim total
$5,405.25
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 270427003
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2020-06-08
- Stop
- 2020-06-08
The parties
- Patient
- patient Chantay Victorina Koepp
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
00c59201-9d52-fccb-211c-1e71a3326825