Claim total
$48,528.21
base $155.66 · payer covered $48,378.21
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-02-17
- Stop
- 2025-02-17
The parties
- Patient
- patient Arlean Deena Stoltenberg
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
08d65f8d-3561-01de-0ad2-bfa357b4a247