Claim total
$4,468.28
base $155.66 · payer covered $4,468.28
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2021-08-22
- Stop
- 2021-08-22
The parties
- Provider
- provider Kiyoko Predovic
- Care site
- care site FAIRVIEW HEALTH SERVICES
Record id
05f1dbc7-3ebc-37ee-025b-e2060eb96d66