Claim total
$7,955.64
base $155.66 · payer covered $7,905.64
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2026-09-15
- Stop
- 2026-09-15
The parties
- Patient
- patient An Wenona Rau
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
04682680-f77d-0a00-2f57-cd43971603e0