Claim total
$38,796.74
base $155.66 · payer covered $38,761.74
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2023-04-21
- Stop
- 2023-04-21
The parties
- Patient
- patient Pamula Ellan Kiehn
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
3a501eb2-e422-6d85-4640-fe315b30f0ab