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
- 2019-03-19
- Stop
- 2019-03-19
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-3cda-0d00bee4a44c