Claim total
$40,706.00
base $155.66 · payer covered $40,656.00
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2022-07-29
- Stop
- 2022-07-29
The parties
- Patient
- patient Ashton Hisako Jaskolski
- Provider
- provider Daryl Farrell
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
2b9209bc-5607-5ae5-33bc-d3c0ab78b0c5