Claim total
$566.96
base $155.66 · payer covered $416.96
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2014-04-16
- Stop
- 2014-04-16
The parties
- Patient
- patient Adán Pablo Acevedo
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
2f74ae9b-159c-cd65-8b90-1df79bbd4b8d