Claim total
$42,892.30
base $155.66 · payer covered $42,857.30
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-08-11
- Stop
- 2018-08-11
The parties
- Patient
- patient Josefina Amanda Kuhic
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
28281b8c-b6b1-f0a9-421f-56dae036aa38