Claim total
$29,715.88
base $155.66 · payer covered $29,565.88
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-07-15
- Stop
- 2024-07-15
The parties
- Provider
- provider Pedro Effertz
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
1be7d604-e5c9-4c1e-0150-f044110d91cb