Claim total
$39,396.81
base $155.66 · payer covered $39,346.81
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2016-12-27
- Stop
- 2016-12-27
The parties
- Patient
- patient Peg Tresa Cummerata
- Provider
- provider Lady Frami
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
04fb4e35-41c7-7592-a5cf-b7ca8264c531