Claim total
$48,630.27
base $155.66 · payer covered $48,580.27
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2021-04-29
- Stop
- 2021-04-29
The parties
- Provider
- provider Pedro Effertz
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
2123ffbe-dcac-b59c-2f16-241b6c0c486b