Claim total
$9,776.08
base $155.66 · payer covered $9,741.08
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2020-08-14
- Stop
- 2020-08-14
The parties
- Patient
- patient Colby Wunsch
- Provider
- provider Charlie Tillman
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Dual Eligible
Record id
02d10ce5-acf0-36ed-3bf0-bd08cf7e1144