Claim total
$20,136.90
base $127.17 · payer covered $20,086.90
The visit
- Class
- Inpatient
- Code
- 183495009
- Reason
- diagnosis concept Injury of anterior cruciate ligament444470001
- Start
- 1972-04-24
- Stop
- 1972-04-26
The parties
- Patient
- patient Leroy Jimmy Wintheiser
- Provider
- provider Omer McLaughlin
- Payer
- payer Medicaid
Record id
04371635-b149-02a5-b61e-d2bdc9e01f66