Claim total
$12,336.02
base $155.66 · payer covered $12,336.02
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2021-12-14
- Stop
- 2021-12-14
The parties
- Provider
- provider Chance Wisoky
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Humana
Record id
032df52f-9699-4603-3a54-d113889357fc