Claim total
$15,921.31
base $93.39 · payer covered $15,886.31
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 1978-10-05
- Stop
- 1978-10-05
The parties
- Patient
- patient Leroy Jimmy Wintheiser
- Provider
- provider Rosio Gleason
- Payer
- payer Dual Eligible
Record id
04371635-b149-02a5-a464-d4055187f38f