Claim total
$14,033.14
base $155.66 · payer covered $13,983.14
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2019-10-30
- Stop
- 2019-10-30
The parties
- Patient
- patient Sha Robin Reilly
- Provider
- provider Trinity Mraz
- Payer
- payer Medicaid
Record id
043d6e13-0cc7-07f3-34b2-fb2fc6379801