Claim total
$43,184.13
base $155.66 · payer covered $43,134.13
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2026-05-12
- Stop
- 2026-05-12
The parties
- Patient
- patient Annamarie Mollie Hoppe
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
0555f11c-c453-57eb-f237-80fd7088aef6