Claim total
$4,611.60
base $155.66 · payer covered $4,561.60
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2021-04-06
- Stop
- 2021-04-06
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Dale Mertz
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-585e-f2a24cb55e67