Claim total
$978.26
base $155.66 · payer covered $782.61
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Blighted ovum35999006
- Start
- 2018-09-24
- Stop
- 2018-09-24
The parties
- Provider
- provider Darnell Reynolds
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
021142be-3a32-af72-9eb9-feac756acfa4