Claim total
$1,109.34
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1992-01-28
- Stop
- 1992-01-28
The parties
- Patient
- patient Sal Graig Wunsch
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Humana
Record id
073f0b4c-738b-da59-3802-7c42a25806a5