Claim total
$5,627.68
base $155.66 · payer covered $5,592.68
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2019-08-12
- Stop
- 2019-08-12
The parties
- Patient
- patient Rosaria Golden Bashirian
- Provider
- provider Ramiro Boehm
- Payer
- payer Dual Eligible
Record id
015dd051-d88b-0f3d-08a4-42deeb2d53f4