Claim total
$43,461.63
base $155.66 · payer covered $33,602.90
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2022-05-25
- Stop
- 2022-05-25
The parties
- Patient
- patient Lecia Ivana Jerde
- Provider
- provider Lady Frami
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer UnitedHealthcare
Record id
3301d0d7-3d54-d3c6-5a3e-fb92945d058e