Claim total
$1,155.50
base $93.83 · payer covered $655.08
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-02-07
- Stop
- 2026-02-07
The parties
- Patient
- patient Amanda Kelsey Daugherty
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Anthem
Record id
00a2ce2f-1e05-ab20-2ff5-7e74235dd679