Claim total
$704.41
base $93.83 · payer covered $386.02
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-11-05
- Stop
- 2016-11-05
The parties
- Patient
- patient Jani Yolando Nitzsche
- Provider
- provider Lyndsey Sipes
- Care site
- care site MORNINGSIDE FAMILY PHYSICIANS
- Payer
- payer Medicare
Record id
04f07ca4-67b1-b65a-2e16-53352d15b3a7