Claim total
$58,855.22
base $155.66 · payer covered $58,805.22
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2016-11-28
- Stop
- 2016-11-28
The parties
- Patient
- patient Digna Merlyn Schaden
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
27115ae7-bc8e-4abc-b6a1-361883be039c