Claim total
$51,312.10
base $155.66 · payer covered $51,262.10
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-12-21
- Stop
- 2024-12-21
The parties
- Provider
- provider Pedro Effertz
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
09a0bc28-8562-d211-d523-d5cc9d4a6d21