Claim total
$17,406.14
base $155.66 · payer covered $17,406.14
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2022-10-09
- Stop
- 2022-10-09
The parties
- Provider
- provider Leila Thiel
- Care site
- care site FAIRVIEW HEALTH SERVICES
Record id
05f1dbc7-3ebc-37ee-681e-1f18ae9451e2