Claim total
$1,041.77
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-08-02
- Stop
- 2022-08-02
The parties
- Patient
- patient Hans Matthew Klocko
- Provider
- provider Lyndsey Sipes
- Care site
- care site MORNINGSIDE FAMILY PHYSICIANS
- Payer
- payer Humana
Record id
0dcefe69-a1de-dc0d-cf7c-e764b8dd3e52