Claim total
$10,905.81
base $155.66 · payer covered $10,855.81
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-06-14
- Stop
- 2025-06-14
The parties
- Patient
- patient Belva Nadene Kuphal
- Provider
- provider Pedro Effertz
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
0430ce7c-cb64-da75-5c05-e7a59eac818c