Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2010-08-27
- Stop
- 2010-08-27
The parties
- Patient
- patient Edythe Nga Pacocha
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
Record id
00cb11fd-f3f7-0950-f6eb-e317a80ba8ab