Claim total
$641.13
base $93.83 · payer covered $512.90
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1980-05-17
- Stop
- 1980-05-17
The parties
- Patient
- patient Amanda Kelsey Daugherty
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicare
Record id
00a2ce2f-1e05-ab20-62f1-56ea1d39ceee