Claim total
$16,311.47
base $155.66 · payer covered $16,261.47
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2019-09-04
- Stop
- 2019-09-04
The parties
- Patient
- patient Sha Robin Reilly
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
043d6e13-0cc7-07f3-6a93-d30db4222d25