Claim total
$5,748.36
base $93.83 · payer covered $4,598.67
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-11-06
- Stop
- 2024-11-06
The parties
- Patient
- patient Elliot Gottlieb
- Provider
- provider Garry Vandervort
- Care site
- care site LIFE LINE COMMUNITY HEALTHCARE
- Payer
- payer Medicare
Record id
18bccce9-570b-f6f7-605b-dca5f8dadea6