Claim total
$36,136.44
base $155.66 · payer covered $18,025.47
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2012-01-16
- Stop
- 2012-01-16
The parties
- Patient
- patient Matha Wanetta Greenholt
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Aetna
Record id
38475c93-5cdf-8ed5-2e3a-ee6e7c7ba9a5