Patient-initiated encounter

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patient Delilah Cleotilde Goldner
Patient-initiated encounter

Claim total

$4,642.26

base $93.39 · payer covered $4,642.26

The visit

Class: Ambulatory
Code: 270427003
Reason: diagnosis concept Normal pregnancy72892002
Start: 2025-06-02
Stop: 2025-06-02

The parties

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

Record id 05f1dbc7-3ebc-37ee-d1d9-5d6142b17c0c