Claim total
$41,823.47
base $155.66 · payer covered $33,458.77
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-07-20
- Stop
- 2025-07-20
The parties
- Patient
- patient Eda So Mante
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer UnitedHealthcare
Record id
2a79084b-df5c-41f9-5013-2e99130dfa8a