Claim total
$10,937.21
base $155.66 · payer covered $10,887.21
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-04-12
- Stop
- 2018-04-12
The parties
- Patient
- patient Johnny Mattie Skiles
- Provider
- provider Irmgard Padberg
- Payer
- payer Medicaid
Record id
01f72a06-0d81-377c-b5a3-d0f5640b089f