Claim total
$1,527.01
base $93.83 · payer covered $980.30
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-01-04
- Stop
- 2020-01-04
The parties
- Patient
- patient Amanda Kelsey Daugherty
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Anthem
Record id
00a2ce2f-1e05-ab20-d1ac-e67001181b07