Claim total
$505.13
base $93.83 · payer covered $404.10
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1975-05-05
- Stop
- 1975-05-05
The parties
- Patient
- patient Eliseo Stewart Baumbach
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicare
Record id
047697e3-dcee-86e1-ac8a-c49df5d9a1b6