Claim total
$16,755.63
base $155.66 · payer covered $16,705.63
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-12-11
- Stop
- 2024-12-11
The parties
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00efc86d-40fa-9fdc-3a7f-6309b650451b