Claim total
$1,650.69
base $93.39 · payer covered $1,600.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Streptococcal sore throat43878008
- Start
- 1974-10-17
- Stop
- 1974-10-17
The parties
- Patient
- patient Ronnie Ina Gusikowski
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
003b30a0-7fd2-f42c-e7af-631754a36dfb