Claim total
$42,873.30
base $155.66 · payer covered $42,723.30
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2017-11-23
- Stop
- 2017-11-23
The parties
- Patient
- patient Kali Glynis Runolfsson
- Provider
- provider Pedro Effertz
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
382a732d-e18f-3704-7cda-ee0f53157724