Claim total
$37,455.20
base $155.66 · payer covered $18,816.72
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2020-03-15
- Stop
- 2020-03-15
The parties
- Patient
- patient Gary Carolynn Bergstrom
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
286699ff-b159-7b1a-6690-0ae0a68fe575