Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1988-12-23
- Stop
- 1988-12-23
The parties
- Patient
- patient Agnus Jaskolski
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer No insurance
Record id
00bd0ed6-396a-5390-e09f-de8c24f4c83c