Claim total
$5,803.61
base $155.66 · payer covered $5,753.61
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2023-03-22
- Stop
- 2023-03-22
The parties
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00efc86d-40fa-9fdc-9975-c11ffe9b45fc