Claim total
$31,165.70
base $155.66 · payer covered $31,115.70
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2016-08-13
- Stop
- 2016-08-13
The parties
- Patient
- patient Alica Tracie Gottlieb
- Provider
- provider Leonora Bechtelar
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
384ec93e-e42b-5355-12bf-65b872f8dfd1