Claim total
$1,046.06
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2005-09-06
- Stop
- 2005-09-06
The parties
- Patient
- patient Stormy Tammera Schimmel
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer No insurance
Record id
10c22f29-deea-9b07-7a75-37f890881318