Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2025-07-04
- Stop
- 2025-07-04
The parties
- Patient
- patient Elias Earl O'Connell
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
321797d2-96a2-8ef1-e72c-c907d0b8db87