Claim total
$51,709.18
base $155.66 · payer covered $27,369.12
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 1976-09-19
- Stop
- 1976-09-19
The parties
- Patient
- patient Verlene Pamula Daniel
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
3123ff91-9b13-6c6f-6fb8-4c1b2b8fc4ed