Claim total
$45,903.65
base $155.66 · payer covered $45,753.65
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2021-12-16
- Stop
- 2021-12-16
The parties
- Patient
- patient Lacy Kattie Cartwright
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
10a5a577-972b-49ae-05e0-2f3085c2089d