Claim total
$44,251.70
base $155.66 · payer covered $44,201.70
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2016-03-25
- Stop
- 2016-03-25
The parties
- Patient
- patient Liz Loriann Kovacek
- Provider
- provider Chance Wisoky
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
31f0e3c1-608c-dfd8-553e-d5eca10f380a