Claim total
$641.13
base $93.83 · payer covered $326.50
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2018-05-30
- Stop
- 2018-05-30
The parties
- Patient
- patient Pok Shane Strosin
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicare
Record id
00162663-d9d1-4955-6417-f2d6016df51a