Claim total
$5,290.88
base $155.66 · payer covered $5,240.88
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2018-08-15
- Stop
- 2018-08-15
The parties
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00efc86d-40fa-9fdc-96a5-54f59843291d