Claim total
$7,903.61
base $155.66 · payer covered $7,853.61
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2019-01-22
- Stop
- 2019-01-22
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-bd03-91c17f6f123f