Claim total
$1,020.01
base $93.83 · payer covered $816.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-10-05
- Stop
- 2025-10-05
The parties
- Patient
- patient Cristy Exie Pouros
- Provider
- provider Lyndsey Sipes
- Care site
- care site MORNINGSIDE FAMILY PHYSICIANS
- Payer
- payer Medicare
Record id
034e20ab-aae7-ddf8-b824-c902a2f1a836