Claim total
$28,114.81
base $155.66 · payer covered $28,064.81
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-12-25
- Stop
- 2018-12-25
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-90ad-cac013ef28d5