Claim total
$35,386.26
base $155.66 · payer covered $35,336.26
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2021-11-26
- Stop
- 2021-11-26
The parties
- Patient
- patient Karrie Lilia Reilly
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
202e9677-3231-9e70-693f-64fe071616fe