Claim total
$9,288.23
base $93.83 · payer covered $9,253.23
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1987-04-30
- Stop
- 1987-04-30
The parties
- Patient
- patient Leroy Jimmy Wintheiser
- Provider
- provider Ramiro Boehm
- Payer
- payer Dual Eligible
Record id
04371635-b149-02a5-691a-c98d373ed78a