Claim total
$978.26
base $155.66 · payer covered $928.26
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Blighted ovum35999006
- Start
- 2021-07-28
- Stop
- 2021-07-28
The parties
- Patient
- patient Deirdre Shannon Hayes
- Provider
- provider Grazyna Sauer
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0194ec83-bb8c-3a71-1489-f3159138d191