Claim total
$37,156.91
base $155.66 · payer covered $37,106.91
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2020-09-08
- Stop
- 2020-09-08
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Dale Mertz
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-710e-6dc348644d91