Claim total
$11,084.51
base $155.66 · payer covered $11,084.51
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2020-11-22
- Stop
- 2020-11-22
The parties
- Provider
- provider Kiyoko Predovic
- Care site
- care site FAIRVIEW HEALTH SERVICES
Record id
05f1dbc7-3ebc-37ee-f262-d7ac983640bd