Claim total
$45,706.00
base $155.66 · payer covered $45,671.00
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2021-07-25
- Stop
- 2021-07-25
The parties
- Patient
- patient Corliss Stormy Shanahan
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
13199f1b-9a57-6e58-554f-e7a6affc47f7