Claim total
$9,571.52
base $155.66 · payer covered $9,521.52
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2020-12-01
- Stop
- 2020-12-01
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-abc8-64e1fdfd0fcb