Claim total
$15,484.76
base $93.39 · payer covered $9,290.85
The visit
- Class
- Ambulatory
- Code
- 270427003
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-05-30
- Stop
- 2024-05-30
The parties
- Patient
- patient Onie Shannon Borer
- Provider
- provider Daryl Farrell
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Aetna
Record id
006af299-d813-2b4f-da0e-48b461b496fd