Claim total
$38,103.73
base $155.66 · payer covered $38,053.73
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2026-01-14
- Stop
- 2026-01-14
The parties
- Patient
- patient Elayne Raynor
- Provider
- provider Charlie Tillman
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
13979d01-bb1a-baed-3d8e-22fe3accdde4