Claim total
$41,958.09
base $155.66 · payer covered $41,908.09
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 1966-03-24
- Stop
- 1966-03-24
The parties
- Patient
- patient Heike Nelida Olson
- Provider
- provider Kiyoko Predovic
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
195810b4-1136-614f-d4da-fefb7737a3bd