Claim total
$1,123.02
base $93.83 · payer covered $716.01
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-09-01
- Stop
- 2019-09-01
The parties
- Patient
- patient Cristy Exie Pouros
- Provider
- provider Lyndsey Sipes
- Care site
- care site MORNINGSIDE FAMILY PHYSICIANS
- Payer
- payer Medicare
Record id
034e20ab-aae7-ddf8-7092-e531d3d58050