Claim total
$9,100.96
base $155.66 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2019-05-28
- Stop
- 2019-05-28
The parties
- Patient
- patient Sherill Ingeborg Wyman
- Provider
- provider Kiyoko Predovic
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
03eccc4c-a1c4-14ad-ee43-c0f8c3f4f7c9