Claim total
$5,289.75
base $155.66 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2019-06-04
- Stop
- 2019-06-04
The parties
- Patient
- patient Sherill Ingeborg Wyman
- Provider
- provider Kiyoko Predovic
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
03eccc4c-a1c4-14ad-0ae2-c680f0199132