Claim total
$978.26
base $155.66 · payer covered $978.26
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Fetus with chromosomal abnormality267253006
- Start
- 2015-05-27
- Stop
- 2015-05-27
The parties
- Provider
- provider Donette Hilpert
- Care site
- care site FAIRVIEW HEALTH SERVICES
Record id
05f1dbc7-3ebc-37ee-f276-b0aba374b7b6