Claim total
$773.83
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2025-10-25
- Stop
- 2025-10-25
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-f0d2-6207212a042e