Claim total
$40,742.52
base $155.66 · payer covered $40,692.52
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2017-12-18
- Stop
- 2017-12-18
The parties
- Patient
- patient Teofila Virgina Tremblay
- Provider
- provider Julee Jones
- Payer
- payer Medicaid
Record id
2571e7af-af29-523c-68af-97913e83d94b