Claim total
$47,330.74
base $155.66 · payer covered $47,280.74
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2023-03-16
- Stop
- 2023-03-16
The parties
- Patient
- patient Malvina Deanne Jacobi
- Provider
- provider Daryl Farrell
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
0f81015e-ddeb-f808-1486-bd45b6f767a5