Claim total
$846.78
base $93.83 · payer covered $746.78
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-02-25
- Stop
- 2022-02-25
The parties
- Patient
- patient Bernetta Dare
- Provider
- provider Lyndsey Sipes
- Care site
- care site MORNINGSIDE FAMILY PHYSICIANS
- Payer
- payer Medicaid
Record id
2253ffad-5335-0a17-4135-8be3c3e6af53