Claim total
$49,007.43
base $155.66 · payer covered $48,857.43
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-08-02
- Stop
- 2018-08-02
The parties
- Provider
- provider Pedro Effertz
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
2123ffbe-dcac-b59c-ed47-6652bc6c25f0