Claim total
$9,644.09
base $155.66 · payer covered $9,594.09
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2020-05-01
- Stop
- 2020-05-01
The parties
- Patient
- patient Carolynn Gabriele Zemlak
- Provider
- provider Darnell Reynolds
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
032e4024-8595-f612-c8ed-c28ceffc907b