Claim total
$45,655.02
base $155.66 · payer covered $45,655.02
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2021-04-18
- Stop
- 2021-04-18
The parties
- Patient
- patient Gary Carolynn Bergstrom
- Provider
- provider Darnell Reynolds
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
286699ff-b159-7b1a-235d-09dacfb138a8