Claim total
$972.90
base $93.39 · payer covered $937.90
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2023-12-01
- Stop
- 2023-12-01
The parties
- Patient
- patient Efren Wilderman
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
0400ef40-232f-be7a-3982-bd0b52473568