Claim total
$42,583.17
base $155.66 · payer covered $42,533.17
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-10-26
- Stop
- 2025-10-26
The parties
- Patient
- patient Gilma Ivy Sporer
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
342f92f5-8a6e-b6a8-159b-291412e9c926