Claim total
$5,290.88
base $155.66 · payer covered $5,240.88
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2017-01-24
- Stop
- 2017-01-24
The parties
- Patient
- patient Peg Tresa Cummerata
- Provider
- provider Noreen Hudson
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
04fb4e35-41c7-7592-2b2a-417f626bdba1