Claim total
$39,228.50
base $155.66 · payer covered $39,178.50
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2021-12-25
- Stop
- 2021-12-25
The parties
- Patient
- patient Sacha Sharita Hodkiewicz
- Provider
- provider Morton Boyer
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
3428133e-e709-f6fe-2d74-1aa34063eba6