Claim total
$1,262.39
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2021-09-29
- Stop
- 2021-09-29
The parties
- Patient
- patient Domingo Jeff Prosacco
- Provider
- provider Vanda Lebsack
- Care site
- care site MORNINGSIDE FAMILY PHYSICIANS
Record id
39eb5ea2-5667-6205-a4c3-df7e7cf49867