Claim total
$39,844.02
base $155.66 · payer covered $39,794.02
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2020-04-27
- Stop
- 2020-04-27
The parties
- Patient
- patient Desire Suzie Simonis
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
307966cc-34e1-e48c-7fde-f180fdc61d38