Claim total
$36,582.32
base $155.66 · payer covered $28,099.46
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2016-11-03
- Stop
- 2016-11-03
The parties
- Patient
- patient Wonda Shields
- Provider
- provider Chance Wisoky
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer UnitedHealthcare
Record id
33704fef-efb6-c12c-6f63-8e2237033b8d