Claim total
$4,468.28
base $155.66 · payer covered $4,418.28
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2019-07-23
- Stop
- 2019-07-23
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Dale Mertz
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-0e80-cd9f580ef9ed