Claim total
$2,048.00
base $155.66 · payer covered $1,998.00
The visit
- Class
- Ambulatory
- Code
- 169762003
- Reason
- —
- Start
- 2019-03-27
- Stop
- 2019-03-27
The parties
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00efc86d-40fa-9fdc-5fc3-a761b6ff1c01