Claim total
$978.26
base $155.66 · payer covered $978.26
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Fetus with chromosomal abnormality267253006
- Start
- 1952-10-07
- Stop
- 1952-10-07
The parties
- Patient
- patient Raye Suzy Gusikowski
- Provider
- provider Verdie Schowalter
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
02c06e54-48b8-2b73-dc4e-567ca9b4eb9a