Claim total
$41,260.88
base $155.66 · payer covered $28,882.62
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-10-11
- Stop
- 2025-10-11
The parties
- Patient
- patient Cierra Lucy Dietrich
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
Record id
1ef7ea10-bba3-6ea9-15f5-5814bc88ebde