Claim total
$980.65
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2008-10-12
- Stop
- 2008-10-12
The parties
- Patient
- patient Cristy Exie Pouros
- Provider
- provider Vanda Lebsack
- Care site
- care site MORNINGSIDE FAMILY PHYSICIANS
- Payer
- payer No insurance
Record id
034e20ab-aae7-ddf8-ee15-823f6e52a51f