Claim total
$1,512.53
base $93.83 · payer covered $1,362.53
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1991-10-09
- Stop
- 1991-10-09
The parties
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicaid
Record id
193e4bb3-7266-1ac6-6dde-76bc3ce39a20