Claim total
$1,123.02
base $93.83 · payer covered $716.81
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-09-24
- Stop
- 2023-09-24
The parties
- Patient
- patient Cristy Exie Pouros
- Provider
- provider Vanda Lebsack
- Care site
- care site MORNINGSIDE FAMILY PHYSICIANS
- Payer
- payer Medicare
Record id
034e20ab-aae7-ddf8-a658-f2215713477a