Claim total
$229.83
base $93.83 · payer covered $79.83
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1980-03-22
- Stop
- 1980-03-22
The parties
- Patient
- patient Lashawna Schmeler
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicaid
Record id
33a13641-be1f-aeac-1fc0-2e8ab3c505d3