Claim total
$46,072.83
base $155.66 · payer covered $26,260.95
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2023-04-23
- Stop
- 2023-04-23
The parties
- Patient
- patient Gary Carolynn Bergstrom
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
286699ff-b159-7b1a-0fbb-2697ae603f35