Claim total
$293.11
base $93.83 · payer covered $48.09
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2017-05-24
- Stop
- 2017-05-24
The parties
- Patient
- patient Pok Shane Strosin
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicare
Record id
00162663-d9d1-4955-6540-817f8ed58ebf