Claim total
$1,416.29
base $93.83 · payer covered $1,133.03
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-01-18
- Stop
- 2021-01-18
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-eebb-f0d4358cb459