Claim total
$1,577.31
base $93.83 · payer covered $1,075.44
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2013-08-04
- Stop
- 2013-08-04
The parties
- Patient
- patient Cristy Exie Pouros
- Provider
- provider Vanda Lebsack
- Care site
- care site MORNINGSIDE FAMILY PHYSICIANS
- Payer
- payer Medicare
Record id
034e20ab-aae7-ddf8-3ecc-f7a11074ec92