Claim total
$6,635.91
base $155.66 · payer covered $6,635.91
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2017-01-13
- Stop
- 2017-01-13
The parties
- Patient
- patient Edythe Nga Pacocha
- Provider
- provider Leta Sipes
Record id
00cb11fd-f3f7-0950-a4ea-7608b0fc9125