Claim total
$30,671.24
base $155.66 · payer covered $30,621.24
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2021-10-04
- Stop
- 2021-10-04
The parties
- Patient
- patient Desire Suzie Simonis
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
307966cc-34e1-e48c-5e77-18712c1cd5e1