Claim total
$8,078.25
base $155.66 · payer covered $8,028.25
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2019-07-09
- Stop
- 2019-07-09
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Jo Stiedemann
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-7043-1b7e546ab508