Claim total
$39,865.40
base $155.66 · payer covered $39,815.40
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2026-03-20
- Stop
- 2026-03-20
The parties
- Patient
- patient Ericka Norma Cole
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
25907c4a-2f11-4f5b-97b4-dc6ff29d3920