Claim total
$8,570.68
base $155.66 · payer covered $8,535.68
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2020-12-26
- Stop
- 2020-12-26
The parties
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
021142be-3a32-af72-68e7-f110c8ff548a