Claim total
$14,514.82
base $155.66 · payer covered $14,464.82
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-06-07
- Stop
- 2018-06-07
The parties
- Patient
- patient Johnny Mattie Skiles
- Provider
- provider Jo Stiedemann
- Payer
- payer Medicaid
Record id
01f72a06-0d81-377c-d9b8-e7bc78b7db71