Claim total
$38,201.27
base $155.66 · payer covered $19,604.53
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-04-15
- Stop
- 2025-04-15
The parties
- Patient
- patient Briana Alana Hickle
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Aetna
Record id
0b3b7c16-0bc2-6fa5-3e01-10ea7813a417