Claim total
$6,725.24
base $155.66 · payer covered $6,675.24
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2017-02-21
- Stop
- 2017-02-21
The parties
- Patient
- patient Peg Tresa Cummerata
- Provider
- provider Silvana Weber
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
04fb4e35-41c7-7592-9937-6bd09702325a