Claim total
$155.66
base $155.66 · payer covered $120.66
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2021-07-10
- Stop
- 2021-07-10
The parties
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
021142be-3a32-af72-8063-e1d14b359076