Claim total
$52,803.79
base $155.66 · payer covered $52,753.79
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-05-26
- Stop
- 2024-05-26
The parties
- Patient
- patient Myrtle Tana Casper
- Provider
- provider Julee Jones
- Payer
- payer Medicaid
Record id
2a4c8829-e297-058f-dc86-6410b56f5e3a