Claim total
$18,638.10
base $155.66 · payer covered $18,588.10
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-12-21
- Stop
- 2024-12-21
The parties
- Patient
- patient Angele Khalilah Kuphal
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
044947be-396f-8eb7-900c-1f60ccbe0739