Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-03-20
- Stop
- 2020-03-20
The parties
- Patient
- patient Agnus Jaskolski
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Humana
Record id
00bd0ed6-396a-5390-e03c-f0b9ef51dc7c