Claim total
$49,893.16
base $155.66 · payer covered $49,843.16
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2022-06-09
- Stop
- 2022-06-09
The parties
- Provider
- provider Pedro Effertz
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
2123ffbe-dcac-b59c-cee7-ea9f150d0a75