Claim total
$33,040.26
base $155.66 · payer covered $32,990.26
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-03-14
- Stop
- 2025-03-14
The parties
- Patient
- patient Ericka Norma Cole
- Provider
- provider Clyde Beier
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
25907c4a-2f11-4f5b-665a-3a3150c68e01