Claim total
$10,507.50
base $155.66 · payer covered $10,457.50
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-02-05
- Stop
- 2025-02-05
The parties
- Provider
- provider Leonora Bechtelar
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00efc86d-40fa-9fdc-892a-5b1579b8688a