Claim total
$6,077.37
base $93.83 · payer covered $6,042.37
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1976-02-26
- Stop
- 1976-02-26
The parties
- Patient
- patient Leroy Jimmy Wintheiser
- Provider
- provider Andria Spinka
- Payer
- payer Dual Eligible
Record id
04371635-b149-02a5-aabd-f17e96a4f9bf