Claim total
$978.26
base $155.66 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Complete miscarriage156073000
- Start
- 2025-11-22
- Stop
- 2025-11-22
The parties
- Patient
- patient Sherill Ingeborg Wyman
- Provider
- provider Bethanie Wintheiser
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
03eccc4c-a1c4-14ad-8d07-b171e7657fb1