Claim total
$1,328.67
base $93.83 · payer covered $880.72
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-08-20
- Stop
- 2017-08-20
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-f82a-a7e6673f8fbb