Claim total
$14,241.59
base $155.66 · payer covered $14,241.59
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2021-05-30
- Stop
- 2021-05-30
The parties
- Provider
- provider Donette Hilpert
- Care site
- care site FAIRVIEW HEALTH SERVICES
Record id
05f1dbc7-3ebc-37ee-1645-015c628691b8