Claim total
$978.26
base $155.66 · payer covered $782.61
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Blighted ovum35999006
- Start
- 2018-05-05
- Stop
- 2018-05-05
The parties
- Provider
- provider Troy Leannon
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer UnitedHealthcare
Record id
06444eb9-3bbb-5546-7233-087d91dbe187