Claim total
$1,037.48
base $93.83 · payer covered $829.98
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-12-03
- Stop
- 2012-12-03
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-c818-a578c58fb8eb