Claim total
$978.26
base $155.66 · payer covered $928.26
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Blighted ovum35999006
- Start
- 2020-02-08
- Stop
- 2020-02-08
The parties
- Patient
- patient Annamarie Mollie Hoppe
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
0555f11c-c453-57eb-1f0c-886896606136