Claim total
$19,892.47
base $155.66 · payer covered $19,857.47
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2021-06-12
- Stop
- 2021-06-12
The parties
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
021142be-3a32-af72-0467-8585ab48cfbf