Claim total
$9,848.76
base $155.66 · payer covered $9,848.76
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2016-08-21
- Stop
- 2016-08-21
The parties
- Patient
- patient Xuan Collier
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
002d4429-df26-5797-fb1a-7601d50dc45e