Claim total
$4,249.70
base $93.39 · payer covered $4,199.70
The visit
- Class
- Ambulatory
- Code
- 270427003
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2026-04-02
- Stop
- 2026-04-02
The parties
- Patient
- patient An Wenona Rau
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
04682680-f77d-0a00-d16c-cb041715620c