Claim total
$4,468.28
base $155.66 · payer covered $4,418.28
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-05-16
- Stop
- 2018-05-16
The parties
- Patient
- patient Mandy Christie Stracke
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00aca497-ef30-85f4-3654-c2a1ac5d8788