Claim total
$40,257.14
base $155.66 · payer covered $20,838.07
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2017-11-11
- Stop
- 2017-11-11
The parties
- Provider
- provider Donette Hilpert
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
12af21a2-f0a0-4eb0-3e1b-3366609e6fb7