Claim total
$12,719.41
base $155.66 · payer covered $12,669.41
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2020-01-28
- Stop
- 2020-01-28
The parties
- Patient
- patient Annamarie Mollie Hoppe
- Provider
- provider Trinity Mraz
- Payer
- payer Medicaid
Record id
0555f11c-c453-57eb-9665-56e30741da2a