Claim total
$42,226.31
base $155.66 · payer covered $42,176.31
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2016-09-23
- Stop
- 2016-09-23
The parties
- Patient
- patient Isela Lisbeth Lang
- Provider
- provider Pasquale Grimes
- Payer
- payer Medicaid
Record id
310def7b-a5c6-df96-dea8-57e3d4235811