Claim total
$2,653.06
base $155.66 · payer covered $2,603.06
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2022-06-27
- Stop
- 2022-06-27
The parties
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00efc86d-40fa-9fdc-12fe-cf10579128a7