Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2011-06-12
- Stop
- 2011-06-12
The parties
- Patient
- patient Leo Ramon Wolf
- Provider
- provider Julene Lemke
- Payer
- payer Cigna Health
Record id
0132d8d5-6e6e-d90f-ff42-a2ad457f1f7f