Prenatal initial visit

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patient Delilah Cleotilde Goldner
Prenatal initial visit

Claim total

$18,189.23

base $155.66 · payer covered $12,650.01

The visit

Class: Ambulatory
Code: 424441002
Reason: diagnosis concept Normal pregnancy72892002
Start: 2025-05-25
Stop: 2025-05-25

The parties

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

Record id 05f1dbc7-3ebc-37ee-7676-722aa169b34b