Claim total
$845.59
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1973-11-20
- Stop
- 1973-11-20
The parties
- Patient
- patient Domenic Brock Dach
- Provider
- provider Lyndsey Sipes
- Care site
- care site MORNINGSIDE FAMILY PHYSICIANS
- Payer
- payer Humana
Record id
19137cbd-9649-bf65-30ca-2beab7a6c74b