Claim total
$40,226.45
base $155.66 · payer covered $40,076.45
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-07-18
- Stop
- 2024-07-18
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-98b8-439a49936fc3