Claim total
$47,007.99
base $155.66 · payer covered $46,957.99
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-11-15
- Stop
- 2025-11-15
The parties
- Patient
- patient Domitila Abshire
- Provider
- provider Daryl Farrell
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
2b74c937-4bd9-de09-c4fc-083c0f4523ec