Claim total
$157.11
base $93.83 · payer covered $125.68
The visit
- Class
- Wellness
- Code
- 308646001
- Reason
- diagnosis concept Pulmonary emphysema87433001
- Start
- 1987-12-10
- Stop
- 1987-12-10
The parties
- Patient
- patient Leroy Jimmy Wintheiser
- Provider
- provider Hazel Effertz
- Payer
- payer Medicare
Record id
04371635-b149-02a5-efa1-998871e485be