Claim total
$4,782.98
base $155.66 · payer covered $4,732.98
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2025-02-19
- Stop
- 2025-02-19
The parties
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00efc86d-40fa-9fdc-4480-ae8c90f8b130