Claim total
$8,941.92
base $155.66 · payer covered $8,941.92
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2022-07-17
- Stop
- 2022-07-17
The parties
- Provider
- provider Kiyoko Predovic
- Care site
- care site FAIRVIEW HEALTH SERVICES
Record id
05f1dbc7-3ebc-37ee-dcec-c0802ba6b96f