Claim total
$8,091.85
base $155.66 · payer covered $8,041.85
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2019-11-25
- Stop
- 2019-11-25
The parties
- Patient
- patient Nana Earlean Kuphal
- Provider
- provider Liz Kozey
- Payer
- payer Medicaid
Record id
01077a3b-80bd-4b83-739c-7823ae404fb5