Claim total
$28,772.99
base $155.66 · payer covered $28,722.99
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2026-04-01
- Stop
- 2026-04-01
The parties
- Patient
- patient Dorotea Mena
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
37466c62-58e6-3416-1c5f-8f3ace2bc166