Claim total
$830.97
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-11-03
- Stop
- 2018-11-03
The parties
- Patient
- patient Buster Lyndon Koepp
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer No insurance
Record id
1ce29cca-26f9-ae28-6e7f-06cb45d148b4