Claim total
$641.13
base $93.83 · payer covered $512.90
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1999-09-20
- Stop
- 1999-09-20
The parties
- Patient
- patient Eliseo Stewart Baumbach
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicare
Record id
047697e3-dcee-86e1-b219-3a6149c1b0c1