Claim total
$38,181.96
base $155.66 · payer covered $38,131.96
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2019-09-26
- Stop
- 2019-09-26
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-f808-9cfe-1836c0e481bc