Claim total
$504.69
base $93.39 · payer covered $396.18
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 1977-01-04
- Stop
- 1977-01-04
The parties
- Patient
- patient Dino Forrest Leuschke
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
2d2c8cd2-088a-6e99-31bc-416b7f3f8230