Claim total
$37,456.63
base $155.66 · payer covered $37,406.63
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2023-08-26
- Stop
- 2023-08-26
The parties
- Patient
- patient Gita Pei Mraz
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
01d312ef-e970-710c-418a-cc7bf9f76c72