Claim total
$45,735.36
base $155.66 · payer covered $45,685.36
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-02-12
- Stop
- 2024-02-12
The parties
- Patient
- patient Celestina Angle Mohr
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
30331ffd-6cb2-e716-d691-8ccf5ab19e1e