Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2000-10-05
- Stop
- 2000-10-05
The parties
- Patient
- patient Kandra Debroah Thiel
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
25c733b1-fb13-5def-826a-f60d7d08f9ec