Claim total
$39,145.93
base $155.66 · payer covered $39,095.93
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2022-10-13
- Stop
- 2022-10-13
The parties
- Patient
- patient Johnsie Jennie Sipes
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
38947f55-f973-1892-f4c0-f94dc6fc24b4