Claim total
$4,236.02
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1999-06-19
- Stop
- 1999-06-19
The parties
- Patient
- patient Milford Damien Miller
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer No insurance
Record id
0dc3f1d4-8eb8-e2f2-4b1d-a06a0e0f3684