Claim total
$9,444.19
base $155.66 · payer covered $9,394.19
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2017-07-25
- Stop
- 2017-07-25
The parties
- Patient
- patient Peg Tresa Cummerata
- Provider
- provider Cory Lynch
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
04fb4e35-41c7-7592-9e21-63270b8a1027