Claim total
$39,324.90
base $155.66 · payer covered $39,274.90
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2016-12-22
- Stop
- 2016-12-22
The parties
- Patient
- patient Tamra Darlena Feeney
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
39f891f2-42e3-2507-0193-9993ab604e7f