Claim total
$5,403.69
base $93.83 · payer covered $4,322.94
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1980-03-20
- Stop
- 1980-03-20
The parties
- Patient
- patient Leroy Jimmy Wintheiser
- Provider
- provider Criselda Bartell
- Payer
- payer Medicare
Record id
04371635-b149-02a5-df75-285961a14ad2