Claim total
$35,892.94
base $155.66 · payer covered $35,857.94
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2023-10-28
- Stop
- 2023-10-28
The parties
- Patient
- patient Demetrius Kellye Brown
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
34d00a16-aef5-c007-2c55-5bd6528be99a