Claim total
$50,970.11
base $155.66 · payer covered $50,920.11
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-02-19
- Stop
- 2018-02-19
The parties
- Patient
- patient Kam Ching Pollich
- Provider
- provider Belkis Blick
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0681ce4b-c984-7822-dbc5-133d9ee99c1a