Claim total
$10,937.21
base $155.66 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-11-15
- Stop
- 2024-11-15
The parties
- Patient
- patient Carolynn Gabriele Zemlak
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer No insurance
Record id
032e4024-8595-f612-56ea-58f7c81abc69