Claim total
$94.86
base $93.39 · payer covered $59.86
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2023-04-19
- Stop
- 2023-04-19
The parties
- Patient
- patient Ángela Carlota Lovato
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
0465c17f-66cb-2155-fa17-ffb8ce83d773