Claim total
$1,008.90
base $93.83 · payer covered $435.15
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2024-11-23
- Stop
- 2024-11-23
The parties
- Patient
- patient Fidelia Linh O'Connell
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer UnitedHealthcare
Record id
0250582d-7796-791e-68d1-f30732d78bd4