Claim total
$847.72
base $93.83 · payer covered $678.17
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-01-21
- Stop
- 2023-01-21
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-a5b2-4754d944c0e7