Claim total
$8,169.98
base $155.66 · payer covered $8,119.98
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-09-18
- Stop
- 2024-09-18
The parties
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00efc86d-40fa-9fdc-7635-1406680982b3