Claim total
$10,937.21
base $155.66 · payer covered $10,887.21
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-02-18
- Stop
- 2025-02-18
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Trinity Mraz
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-1d66-410a241be5f6