Claim total
$978.26
base $155.66 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Complete miscarriage156073000
- Start
- 1976-04-03
- Stop
- 1976-04-03
The parties
- Patient
- patient Latrisha Simonne Kuhlman
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
0277738c-b3e3-4ada-28de-078e2f996456