Claim total
$4,249.70
base $93.39 · payer covered $4,214.70
The visit
- Class
- Ambulatory
- Code
- 270427003
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2021-01-30
- Stop
- 2021-01-30
The parties
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
021142be-3a32-af72-a81e-e3423d7dc54e