Claim total
$5,129.12
base $155.66 · payer covered $5,079.12
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-07-05
- Stop
- 2018-07-05
The parties
- Patient
- patient Johnny Mattie Skiles
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
01f72a06-0d81-377c-fa67-1c0db6e64d19