Claim total
$155.66
base $155.66 · payer covered $105.66
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2021-05-14
- Stop
- 2021-05-14
The parties
- Patient
- patient Carolynn Gabriele Zemlak
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
032e4024-8595-f612-3238-b714108df5aa