Claim total
$45,031.81
base $155.66 · payer covered $44,981.81
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2026-03-21
- Stop
- 2026-03-21
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-4bed-8e2e06c973e6