Claim total
$35,189.44
base $155.66 · payer covered $35,139.44
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-08-10
- Stop
- 2025-08-10
The parties
- Patient
- patient Chelsea Lillie Connelly
- Provider
- provider Darnell Reynolds
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
15e4e886-ae0d-3af0-0b4e-aff98e41dedd