Claim total
$12,754.44
base $155.66 · payer covered $12,704.44
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2016-10-17
- Stop
- 2016-10-17
The parties
- Patient
- patient Nana Earlean Kuphal
- Provider
- provider Floyd Toy
- Payer
- payer Medicaid
Record id
01077a3b-80bd-4b83-8a4f-2dd5b870e70e