Claim total
$10,489.98
base $155.66 · payer covered $10,489.98
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2017-02-05
- Stop
- 2017-02-05
The parties
- Patient
- patient Xuan Collier
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
002d4429-df26-5797-99e4-e3f3592b4086