Claim total
$7,169.20
base $155.66 · payer covered $7,119.20
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-03-21
- Stop
- 2018-03-21
The parties
- Patient
- patient Mandy Christie Stracke
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00aca497-ef30-85f4-394c-9bdaf3735551