Claim total
$1,035.18
base $93.83 · payer covered $885.18
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1977-04-20
- Stop
- 1977-04-20
The parties
- Patient
- patient Gene Erin Wehner
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicaid
Record id
0324eea5-bb16-c29a-030b-edbd77a98d34