Claim total
$857.28
base $93.83 · payer covered $522.46
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-10-31
- Stop
- 2015-10-31
The parties
- Patient
- patient Jani Yolando Nitzsche
- Provider
- provider Vanda Lebsack
- Care site
- care site MORNINGSIDE FAMILY PHYSICIANS
- Payer
- payer Medicare
Record id
04f07ca4-67b1-b65a-4d46-afc8a1c3aa4c