Claim total
$1,083.02
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2021-11-21
- Stop
- 2021-11-21
The parties
- Patient
- patient Carley Marla Von
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Humana
Record id
032fec8b-a285-8108-fefd-d78ee781b952