Claim total
$53,617.88
base $155.66 · payer covered $53,567.88
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-03-27
- Stop
- 2025-03-27
The parties
- Patient
- patient Malvina Deanne Jacobi
- Provider
- provider Daryl Farrell
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
0f81015e-ddeb-f808-7a52-caf0b92ec1f3