Claim total
$31,842.77
base $155.66 · payer covered $31,792.77
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-09-05
- Stop
- 2024-09-05
The parties
- Provider
- provider Pedro Effertz
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
2123ffbe-dcac-b59c-e6e0-74103b20263c