Claim total
$11,907.73
base $155.66 · payer covered $11,857.73
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2022-12-28
- Stop
- 2022-12-28
The parties
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00efc86d-40fa-9fdc-522a-d8d0fc2ed8e5