Claim total
$31,688.91
base $155.66 · payer covered $31,638.91
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-08-14
- Stop
- 2018-08-14
The parties
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0f8011da-3f5b-ae5a-fe48-bd8b2da950ca