Claim total
$6,261.88
base $155.66 · payer covered $6,211.88
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2019-11-13
- Stop
- 2019-11-13
The parties
- Patient
- patient Sha Robin Reilly
- Provider
- provider Trinity Mraz
- Payer
- payer Medicaid
Record id
043d6e13-0cc7-07f3-17e6-96e84486b260