Claim total
$4,468.28
base $155.66 · payer covered $4,418.28
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2019-10-02
- Stop
- 2019-10-02
The parties
- Patient
- patient Sha Robin Reilly
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
043d6e13-0cc7-07f3-767d-cece63b70984