Claim total
$48,992.41
base $155.66 · payer covered $48,842.41
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2021-03-19
- Stop
- 2021-03-19
The parties
- Patient
- patient Carolynn Gabriele Zemlak
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
032e4024-8595-f612-02c3-09b9a326b03b