Claim total
$223.76
base $93.39 · payer covered $188.76
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 1986-05-15
- Stop
- 1986-05-15
The parties
- Patient
- patient Leroy Jimmy Wintheiser
- Provider
- provider Antonietta Purdy
- Payer
- payer Dual Eligible
Record id
04371635-b149-02a5-18df-787efeaf63fa