Claim total
$11,056.05
base $155.66 · payer covered $11,006.05
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-08-21
- Stop
- 2024-08-21
The parties
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00efc86d-40fa-9fdc-b266-9efd8e292bac