Claim total
$18,937.56
base $155.66 · payer covered $18,887.56
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2020-07-24
- Stop
- 2020-07-24
The parties
- Patient
- patient Carolynn Gabriele Zemlak
- Provider
- provider Morton Boyer
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
032e4024-8595-f612-2fc1-5575bbaf90c0