Claim total
$6,266.06
base $93.83 · payer covered $6,231.06
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1986-04-24
- Stop
- 1986-04-24
The parties
- Patient
- patient Leroy Jimmy Wintheiser
- Provider
- provider Criselda Bartell
- Payer
- payer Dual Eligible
Record id
04371635-b149-02a5-c936-7edaf9713821