Claim total
$17,406.14
base $155.66 · payer covered $17,356.14
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-01-24
- Stop
- 2018-01-24
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-f78f-ef72fead04c6