Claim total
$1,186.30
base $93.83 · payer covered $767.31
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-08-09
- Stop
- 2015-08-09
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-ddf8-7abc-c077a4deb35a