Claim total
$1,185.08
base $93.83 · payer covered $1,128.47
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-12-01
- Stop
- 2023-12-01
The parties
- Patient
- patient Lamar Dalton Wehner
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicaid
Record id
0a5a56bf-f069-44b4-b27f-9e7d513306fc