Claim total
$4,468.28
base $155.66 · payer covered $4,418.28
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2026-09-01
- Stop
- 2026-09-01
The parties
- Patient
- patient Annamarie Mollie Hoppe
- Provider
- provider Jo Stiedemann
- Payer
- payer Medicaid
Record id
0555f11c-c453-57eb-5dca-1ee9caa57fdf