Claim total
$1,396.14
base $155.66 · payer covered $1,346.14
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2026-04-09
- Stop
- 2026-04-09
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-e7e5-f9ad4639306d