Claim total
$10,894.31
base $155.66 · payer covered $10,859.31
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2020-02-01
- Stop
- 2020-02-01
The parties
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
021142be-3a32-af72-3ad4-86014710e778