Claim total
$978.26
base $155.66 · payer covered $978.26
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Complete miscarriage156073000
- Start
- 2020-09-22
- Stop
- 2020-09-22
The parties
- Patient
- patient Onie Shannon Borer
- Provider
- provider Daryl Farrell
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Cigna Health
Record id
006af299-d813-2b4f-812b-2fe358c7ae00