Claim total
$978.26
base $155.66 · payer covered $928.26
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Fetus with chromosomal abnormality267253006
- Start
- 1984-06-24
- Stop
- 1984-06-24
The parties
- Patient
- patient Rocio Margarita Alcaraz
- Provider
- provider Pasquale Grimes
- Payer
- payer Medicaid
Record id
0274bb53-c777-eb96-c932-16d882525b42