Claim total
$15,033.86
base $155.66 · payer covered $14,883.86
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-09-17
- Stop
- 2024-09-17
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Irmgard Padberg
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-0b60-6a4e0862996c