Claim total
$12,641.92
base $155.66 · payer covered $9,927.14
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2019-08-30
- Stop
- 2019-08-30
The parties
- Patient
- patient Colby Wunsch
- Provider
- provider Charlie Tillman
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicare
Record id
02d10ce5-acf0-36ed-ef0d-ed14c965611e