Claim total
$33,360.17
base $155.66 · payer covered $17,111.36
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-05-18
- Stop
- 2024-05-18
The parties
- Patient
- patient Deidra Estell Ratke
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
24c555cb-8a8b-be81-6ce8-8d0626a46f3e