Claim total
$47,371.56
base $155.66 · payer covered $47,321.56
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2016-02-29
- Stop
- 2016-02-29
The parties
- Patient
- patient Libby Celine Gorczany
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
369882ce-78fe-11ba-0aa8-a22ace9429ed