Claim total
$12,656.25
base $155.66 · payer covered $12,606.25
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-11-13
- Stop
- 2024-11-13
The parties
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00efc86d-40fa-9fdc-d31e-66594259d7e4