Claim total
$9,969.75
base $155.66 · payer covered $9,969.75
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-06-04
- Stop
- 2024-06-04
The parties
- Provider
- provider Stuart Bergnaum
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Humana
Record id
032df52f-9699-4603-abcd-0ee919206529