Claim total
$1,411.39
base $93.83 · payer covered $954.56
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-12-04
- Stop
- 2021-12-04
The parties
- Patient
- patient Jani Yolando Nitzsche
- Provider
- provider Lyndsey Sipes
- Care site
- care site MORNINGSIDE FAMILY PHYSICIANS
- Payer
- payer Medicare
Record id
04f07ca4-67b1-b65a-ac5e-bd611a976c4c