Claim total
$14,227.61
base $155.66 · payer covered $14,177.61
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-04-30
- Stop
- 2025-04-30
The parties
- Patient
- patient Mandy Christie Stracke
- Provider
- provider Boris Lynch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00aca497-ef30-85f4-4e00-35e95dc267c8