Claim total
$978.26
base $155.66 · payer covered $978.26
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Complete miscarriage156073000
- Start
- 2011-01-24
- Stop
- 2011-01-24
The parties
- Patient
- patient Nichol Clara Predovic
- Provider
- provider Dusti Satterfield
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
0130f9d2-4df9-4b02-deba-20869deb3b81