Claim total
$39,674.11
base $155.66 · payer covered $39,524.11
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2016-04-28
- Stop
- 2016-04-28
The parties
- Patient
- patient Jeanice Rene Upton
- Provider
- provider Darnell Reynolds
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
393ec674-f74f-a54b-d0b9-caa8855c42f9