Claim total
$773.83
base $93.83 · payer covered $673.83
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2020-05-11
- Stop
- 2020-05-11
The parties
- Patient
- patient Samuel Earnest Turcotte
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicaid
Record id
05c29541-7f3e-5d79-4080-0bbd3071bcd4