Claim total
$41,105.81
base $155.66 · payer covered $40,955.81
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-08-31
- Stop
- 2018-08-31
The parties
- Patient
- patient Fay Danyell Wilderman
- Provider
- provider Pedro Effertz
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
310f7b88-3df4-237f-41db-914ea8596c14