Claim total
$52,513.92
base $155.66 · payer covered $34,127.24
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-03-28
- Stop
- 2024-03-29
The parties
- Patient
- patient Reta Thora Bogan
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
Record id
2f14578f-142e-120d-e39b-e22ece0f3816