Claim total
$9,447.08
base $155.66 · payer covered $9,397.08
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-08-23
- Stop
- 2018-08-23
The parties
- Patient
- patient Johnny Mattie Skiles
- Provider
- provider Jo Stiedemann
- Payer
- payer Medicaid
Record id
01f72a06-0d81-377c-9168-bd46a8f1086f