Claim total
$13,485.84
base $155.66 · payer covered $13,435.84
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-12-11
- Stop
- 2018-12-11
The parties
- Patient
- patient Queen Sharika Fay
- Provider
- provider Daryl Farrell
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
02c148c0-182c-a5fd-713c-66a240c44077