Claim total
$1,713.60
base $155.66 · payer covered $1,370.88
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-09-24
- Stop
- 2024-09-24
The parties
- Patient
- patient Dora Violet Okuneva
- Provider
- provider Liz Kozey
- Payer
- payer Anthem
Record id
001727b6-dbde-2493-7760-97124dd273c3