Claim total
$9,939.43
base $155.66 · payer covered $9,789.43
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2026-08-04
- Stop
- 2026-08-04
The parties
- Patient
- patient Annamarie Mollie Hoppe
- Provider
- provider Pasquale Grimes
- Payer
- payer Medicaid
Record id
0555f11c-c453-57eb-e8d0-31b15595b279