Claim total
$775.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2008-10-13
- Stop
- 2008-10-13
The parties
- Patient
- patient Kanesha Spring Cummerata
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Humana
Record id
0d968006-46f3-aae8-1226-1329220fd462