Claim total
$35,253.86
base $155.66 · payer covered $35,103.86
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2020-12-14
- Stop
- 2020-12-14
The parties
- Patient
- patient Arlean Deena Stoltenberg
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
08d65f8d-3561-01de-3da0-e59fdaf22cc5