Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1989-09-17
- Stop
- 1989-09-17
The parties
- Patient
- patient Cristy Exie Pouros
- Provider
- provider Lyndsey Sipes
- Care site
- care site MORNINGSIDE FAMILY PHYSICIANS
- Payer
- payer No insurance
Record id
034e20ab-aae7-ddf8-86ef-56099a0a0b94