Claim total
$4,249.70
base $93.39 · payer covered $4,199.70
The visit
- Class
- Ambulatory
- Code
- 270427003
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2022-06-13
- Stop
- 2022-06-13
The parties
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00efc86d-40fa-9fdc-9400-b93ed560318a