Claim total
$17,819.36
base $155.66 · payer covered $9,816.64
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2020-07-12
- Stop
- 2020-07-12
The parties
- Provider
- provider Donette Hilpert
- Care site
- care site FAIRVIEW HEALTH SERVICES
Record id
05f1dbc7-3ebc-37ee-c74e-bba6ace0bb2f