Claim total
$42,719.91
base $155.66 · payer covered $42,569.91
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2023-07-06
- Stop
- 2023-07-06
The parties
- Patient
- patient Jeanice Rene Upton
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
393ec674-f74f-a54b-23f9-c1493cb9a16a