Claim total
$33,765.20
base $155.66 · payer covered $33,615.20
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2017-04-15
- Stop
- 2017-04-15
The parties
- Patient
- patient Le Rosella Marks
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
08d0bbfe-3183-9cfc-751a-de19ab42476a