Claim total
$6,233.34
base $93.83 · payer covered $6,198.34
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1978-03-09
- Stop
- 1978-03-09
The parties
- Patient
- patient Leroy Jimmy Wintheiser
- Provider
- provider Kelvin Reichel
- Payer
- payer Dual Eligible
Record id
04371635-b149-02a5-8b42-b82aa9b73a96