Claim total
$28,149.77
base $155.66 · payer covered $28,099.77
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2020-06-24
- Stop
- 2020-06-24
The parties
- Patient
- patient Emerald Katie Jerde
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
24d0e6e5-8a87-707b-7b3a-55f5db3ab9af