Claim total
$17,756.05
base $155.66 · payer covered $17,706.05
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2023-02-18
- Stop
- 2023-02-18
The parties
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
04424811-b26b-3a54-fb86-4f803c2a940b