Claim total
$978.26
base $155.66 · payer covered $928.26
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Complete miscarriage156073000
- Start
- 2023-03-03
- Stop
- 2023-03-03
The parties
- Provider
- provider Clyde Beier
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
04424811-b26b-3a54-afb7-b735c8b4fb71