Claim total
$640.69
base $93.39 · payer covered $590.69
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2025-02-05
- Stop
- 2025-02-05
The parties
- Patient
- patient Adam Alfonzo Stokes
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
056ed411-c295-a5c9-1ecd-a3bf9b5c2e38