Claim total
$6,172.99
base $155.66 · payer covered $47.39
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2016-12-17
- Stop
- 2016-12-18
The parties
- Patient
- patient Corrina Leontine Smith
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
03b48c3f-9d97-2f75-7bfc-c8d836800cd1