Claim total
$978.26
base $155.66 · payer covered $928.26
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Complete miscarriage156073000
- Start
- 2008-07-15
- Stop
- 2008-07-15
The parties
- Patient
- patient Jacqui Bess Baumbach
- Provider
- provider Lanora Schowalter
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
019cda32-2557-7f65-779c-22110cb3a610