Claim total
$42,001.34
base $155.66 · payer covered $33,414.67
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2015-07-31
- Stop
- 2015-07-31
The parties
- Patient
- patient Mignon Janay Johnson
- Provider
- provider Charlie Tillman
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicare
Record id
0a37331a-7bd1-f3a9-d00e-aaccf0ebb878