Claim total
$4,222.52
base $93.83 · payer covered $2,211.62
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1947-06-22
- Stop
- 1947-06-22
The parties
- Patient
- patient Claudie Angeles Von
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer UnitedHealthcare
Record id
23c8ce80-e14c-e470-a246-d209b60fc868