Claim total
$9,251.52
base $155.66 · payer covered $9,201.52
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2021-04-16
- Stop
- 2021-04-16
The parties
- Patient
- patient Carolynn Gabriele Zemlak
- Provider
- provider Walter Volkman
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
032e4024-8595-f612-a5a6-15bc8167aeeb