Claim total
$866.58
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2011-09-02
- Stop
- 2011-09-02
The parties
- Patient
- patient Edythe Nga Pacocha
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
Record id
00cb11fd-f3f7-0950-cb9c-7c06acf1df63