Claim total
$13,540.78
base $155.66 · payer covered $13,505.78
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2020-06-19
- Stop
- 2020-06-19
The parties
- Patient
- patient Colby Wunsch
- Provider
- provider Chance Wisoky
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Dual Eligible
Record id
02d10ce5-acf0-36ed-e847-e33492be742d