Claim total
$30,499.42
base $155.66 · payer covered $30,449.42
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-01-13
- Stop
- 2025-01-13
The parties
- Patient
- patient Thu Sunni Funk
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
32486fb2-66f7-813c-1cb2-9ad7648244c8