Claim total
$40,764.22
base $155.66 · payer covered $40,714.22
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 1957-11-25
- Stop
- 1957-11-25
The parties
- Patient
- patient Geralyn Berniece Kirlin
- Provider
- provider Pedro Effertz
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
18ec76c4-019a-43be-63ce-adc485afaf47