Claim total
$42,839.08
base $155.66 · payer covered $22,387.24
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2023-05-20
- Stop
- 2023-05-20
The parties
- Patient
- patient Deidra Estell Ratke
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
24c555cb-8a8b-be81-b70b-495a98a5aa00