Claim total
$6,172.99
base $155.66 · payer covered $6,022.99
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2020-08-05
- Stop
- 2020-08-05
The parties
- Patient
- patient Mandy Christie Stracke
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00aca497-ef30-85f4-669e-4b1e9334e1ba