Claim total
$10,937.21
base $155.66 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-06-20
- Stop
- 2018-06-20
The parties
- Patient
- patient Carlyn Donita Ortiz
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
00e3929f-91f8-0715-3768-a6516242f979