Claim total
$5,609.34
base $93.83 · payer covered $5,574.34
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1983-04-07
- Stop
- 1983-04-07
The parties
- Patient
- patient Leroy Jimmy Wintheiser
- Provider
- provider Lovie Turcotte
- Payer
- payer Dual Eligible
Record id
04371635-b149-02a5-25ec-301905b625fd