Claim total
$42,213.77
base $155.66 · payer covered $42,063.77
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2022-07-04
- Stop
- 2022-07-04
The parties
- Patient
- patient Celestina Angle Mohr
- Provider
- provider Walter Volkman
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
30331ffd-6cb2-e716-c682-10e715e9056f