Claim total
$15,030.47
base $93.83 · payer covered $14,995.47
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1985-04-18
- Stop
- 1985-04-18
The parties
- Patient
- patient Leroy Jimmy Wintheiser
- Provider
- provider Kim Lind
- Payer
- payer Dual Eligible
Record id
04371635-b149-02a5-b966-6878e3e5886d