Claim total
$978.26
base $155.66 · payer covered $928.26
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Complete miscarriage156073000
- Start
- 2013-12-12
- Stop
- 2013-12-12
The parties
- Patient
- patient Nana Earlean Kuphal
- Provider
- provider Marcus Douglas
- Payer
- payer Medicaid
Record id
01077a3b-80bd-4b83-d1c9-97f3c362d2c7