Claim total
$47,102.08
base $155.66 · payer covered $36,515.27
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-01-11
- Stop
- 2018-01-11
The parties
- Patient
- patient Wonda Shields
- Provider
- provider Stuart Bergnaum
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer UnitedHealthcare
Record id
33704fef-efb6-c12c-c7be-b7af70d6fcea