Claim total
$36,934.89
base $155.66 · payer covered $36,884.89
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2019-03-28
- Stop
- 2019-03-28
The parties
- Patient
- patient Kenia Elida Terry
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
09a3167a-b9be-61ba-1a0e-ab177b7851d3