Claim total
$14,769.74
base $155.66 · payer covered $14,619.74
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-05-10
- Stop
- 2018-05-10
The parties
- Patient
- patient Johnny Mattie Skiles
- Provider
- provider Burton O'Conner
- Payer
- payer Medicaid
Record id
01f72a06-0d81-377c-504d-846271dfb89c