Claim total
$1,049.08
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1970-11-17
- Stop
- 1970-11-17
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-a68d-d6607c5cd9df