Claim total
$5,290.88
base $155.66 · payer covered $5,240.88
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-02-04
- Stop
- 2025-02-04
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Irmgard Padberg
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-fc64-4dae9329ef8c