Claim total
$43,643.03
base $155.66 · payer covered $43,593.03
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2021-06-03
- Stop
- 2021-06-03
The parties
- Patient
- patient Maia Chelsie Runolfsson
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
171169a6-b136-3c65-9ca2-f5b296e1097a