Claim total
$5,735.90
base $93.83 · payer covered $5,685.90
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1982-04-01
- Stop
- 1982-04-01
The parties
- Patient
- patient Leroy Jimmy Wintheiser
- Provider
- provider Andria Spinka
- Payer
- payer Medicaid
Record id
04371635-b149-02a5-40d2-a7d08f72d6e0