Claim total
$11,761.54
base $155.66 · payer covered $11,711.54
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-05-28
- Stop
- 2025-05-28
The parties
- Patient
- patient Amanda Rheba Mitchell
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0363ed75-83f4-7675-40ca-2387cc972445