Claim total
$4,672.05
base $155.66 · payer covered $4,622.05
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2019-06-11
- Stop
- 2019-06-11
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Irmgard Padberg
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-b055-794e5ebc811a