Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2013-09-30
- Stop
- 2013-09-30
The parties
- Patient
- patient Sandy Salvador Will
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
Record id
05317da0-053c-0c68-65e5-6edbe0bf4444