Claim total
$47,517.25
base $155.66 · payer covered $47,467.25
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2026-03-17
- Stop
- 2026-03-17
The parties
- Patient
- patient Wava Darline Homenick
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
2f3cc0ac-84f9-d742-9a9a-c33e5276d4fb