Claim total
$11,759.81
base $155.66 · payer covered $11,709.81
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-02-15
- Stop
- 2018-02-15
The parties
- Patient
- patient Johnny Mattie Skiles
- Provider
- provider Jo Stiedemann
- Payer
- payer Medicaid
Record id
01f72a06-0d81-377c-8b2a-318e5347fa77