Claim total
$1,115.43
base $93.83 · payer covered $965.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1992-05-16
- Stop
- 1992-05-16
The parties
- Patient
- patient Lashawna Schmeler
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicaid
Record id
33a13641-be1f-aeac-6925-e2aa357a4a0c