Claim total
$12,810.04
base $155.66 · payer covered $12,810.04
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2016-09-18
- Stop
- 2016-09-18
The parties
- Patient
- patient Xuan Collier
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
002d4429-df26-5797-21df-e20a4a581801