Claim total
$780.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1990-02-16
- Stop
- 1990-02-16
The parties
- Patient
- patient Marvin Freddie Fisher
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer No insurance
Record id
2fabcc2d-ad4a-b3ba-7520-f32fb3127564