Claim total
$40,470.17
base $155.66 · payer covered $24,282.11
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2022-12-03
- Stop
- 2022-12-03
The parties
- Patient
- patient Lizette Ardella Dicki
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Aetna
Record id
31c17b80-43b3-1002-a289-3f31abba4a5e