Claim total
$773.83
base $93.83 · payer covered $773.83
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2019-11-11
- Stop
- 2019-11-11
The parties
- Patient
- patient Samuel Earnest Turcotte
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicaid
Record id
05c29541-7f3e-5d79-5a3d-4fe1584c9499