Claim total
$40,436.05
base $155.66 · payer covered $40,386.05
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-02-03
- Stop
- 2024-02-03
The parties
- Patient
- patient Concetta Pat Boehm
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
1aab82e0-bdd8-4de0-8a3b-3e79cb6a970b