Claim total
$43,749.72
base $155.66 · payer covered $26,249.83
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2023-06-27
- Stop
- 2023-06-27
The parties
- Patient
- patient Shakira Toccara Stamm
- Provider
- provider Rebeca Lomeli
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
3921b8e6-ecee-d231-150a-f42558a54ea6