Claim total
$42,056.11
base $155.66 · payer covered $41,906.11
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2026-08-24
- Stop
- 2026-08-24
The parties
- Patient
- patient Desire Suzie Simonis
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
307966cc-34e1-e48c-777b-95fd163c41bf