Claim total
$35,694.38
base $155.66 · payer covered $35,644.38
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-11-26
- Stop
- 2018-11-26
The parties
- Patient
- patient Doris Heathcote
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
18a48ad3-860f-6d9d-9002-e96671c8f28a