Claim total
$14,661.62
base $155.66 · payer covered $14,661.62
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2022-01-11
- Stop
- 2022-01-11
The parties
- Provider
- provider Stuart Bergnaum
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Humana
Record id
032df52f-9699-4603-baf0-9c5af1f42dd8