Claim total
$13,831.32
base $155.66 · payer covered $13,781.32
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-10-15
- Stop
- 2024-10-15
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Irmgard Padberg
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-375e-b166b10f53b0