Claim total
$13,319.43
base $155.66 · payer covered $13,319.43
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2017-01-22
- Stop
- 2017-01-22
The parties
- Patient
- patient Xuan Collier
- Provider
- provider Morton Boyer
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
002d4429-df26-5797-1288-0902c9e3d827