Claim total
$9,719.05
base $155.66 · payer covered $9,669.05
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-08-16
- Stop
- 2018-08-16
The parties
- Patient
- patient Johnny Mattie Skiles
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
01f72a06-0d81-377c-f360-5f4a7f591eb8