Claim total
$43,932.62
base $155.66 · payer covered $43,882.62
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-07-12
- Stop
- 2025-07-12
The parties
- Patient
- patient Ilene Steuber
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
1cab5c3e-320a-1ffa-88f4-d8543bbd9296