Claim total
$155.66
base $155.66 · payer covered $120.66
The visit
- Class
- Ambulatory
- Code
- 281036007
- Reason
- diagnosis concept Alzheimer's disease26929004
- Start
- 2025-04-27
- Stop
- 2025-04-27
The parties
- Patient
- patient Efren Wilderman
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
0400ef40-232f-be7a-c34e-64266bddd7c6