Claim total
$41,205.10
base $155.66 · payer covered $41,055.10
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2021-06-20
- Stop
- 2021-06-20
The parties
- Patient
- patient Kala Margorie Orn
- Provider
- provider Pedro Effertz
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
276d3050-5024-a041-af50-d4ab366ab4fa