Claim total
$978.26
base $155.66 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Blighted ovum35999006
- Start
- 1981-02-22
- Stop
- 1981-02-22
The parties
- Patient
- patient Alyson Janie Marquardt
- Provider
- provider Penni Kuphal
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer No insurance
Record id
00faac37-85e6-9663-c9fc-7c8e43021b7a