Claim total
$12,363.77
base $155.66 · payer covered $12,328.77
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2019-06-17
- Stop
- 2019-06-17
The parties
- Patient
- patient Rosaria Golden Bashirian
- Provider
- provider Kelvin Reichel
- Payer
- payer Dual Eligible
Record id
015dd051-d88b-0f3d-b853-8be4a44db561