Claim total
$843.43
base $93.83 · payer covered $693.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1990-04-11
- Stop
- 1990-04-11
The parties
- Patient
- patient Ramon Josef Hagenes
- Provider
- provider Lyndsey Sipes
- Care site
- care site MORNINGSIDE FAMILY PHYSICIANS
- Payer
- payer Medicaid
Record id
358aeebf-9459-7875-135f-140ec24c4660