Claim total
$45,009.59
base $155.66 · payer covered $44,959.59
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2015-08-13
- Stop
- 2015-08-13
The parties
- Patient
- patient Augustina Ana Shanahan
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
314bf5ed-ef43-7062-df84-f7f0ba1a6799