Claim total
$13,211.36
base $155.66 · payer covered $13,161.36
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-08-20
- Stop
- 2024-08-20
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Burton O'Conner
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-b6aa-6a842cee46de