Claim total
$775.00
base $93.83 · payer covered $436.94
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2006-08-25
- Stop
- 2006-08-25
The parties
- Patient
- patient Eva Duran
- Provider
- provider Vanda Lebsack
- Care site
- care site MORNINGSIDE FAMILY PHYSICIANS
- Payer
- payer Medicare
Record id
2a651a9e-ca88-4c92-301f-f300d329fbf2