Claim total
$23,537.00
base $155.66 · payer covered $23,487.00
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-12-10
- Stop
- 2024-12-10
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Pasquale Grimes
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-2929-6f6aa660e266