Claim total
$42,851.53
base $155.66 · payer covered $42,701.53
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2023-06-21
- Stop
- 2023-06-21
The parties
- Patient
- patient Larraine Zita Robel
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
2df46b25-4cd4-6fa2-81d2-86551defd3e2