Claim total
$43,438.01
base $155.66 · payer covered $43,388.01
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2023-09-19
- Stop
- 2023-09-19
The parties
- Patient
- patient Gwyn Priscilla Spinka
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
2bcfe7e7-608a-8690-f0d9-e3b81ba5e393