Claim total
$13,909.97
base $155.66 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-07-18
- Stop
- 2018-07-18
The parties
- Patient
- patient Carlyn Donita Ortiz
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
00e3929f-91f8-0715-2269-80c50ff13dfe