Claim total
$14,051.53
base $155.66 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-01-10
- Stop
- 2025-01-10
The parties
- Patient
- patient Carolynn Gabriele Zemlak
- Provider
- provider Darnell Reynolds
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer No insurance
Record id
032e4024-8595-f612-b26c-c0d8dbb4962e