Claim total
$57,984.65
base $155.66 · payer covered $57,949.65
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2021-05-15
- Stop
- 2021-05-15
The parties
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
021142be-3a32-af72-49d7-a46e39955129