Claim total
$314.90
base $93.39 · payer covered $264.90
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2020-05-15
- Stop
- 2020-05-15
The parties
- Patient
- patient Efren Wilderman
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0400ef40-232f-be7a-ff01-349e9d1bbe78