Prenatal visit

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Claim total

$1,396.14

base $155.66 · payer covered $1,396.14

The visit

Class: Ambulatory
Code: 424619006
Reason: diagnosis concept Normal pregnancy72892002
Start: 2019-06-03
Stop: 2019-06-03

The parties

Patient: patient Delilah Cleotilde Goldner
Provider: provider Joshua Dickens
Care site: care site FAIRVIEW HEALTH SERVICES
Payer: payer Blue Cross Blue Shield

Record id 05f1dbc7-3ebc-37ee-1718-f1602685d4ca