Claim total
$17,406.14
base $155.66 · payer covered $17,356.14
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-01-18
- Stop
- 2025-01-18
The parties
- Patient
- patient Angele Khalilah Kuphal
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
044947be-396f-8eb7-a1d2-e593273d55fb