Claim total
$1,336.89
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1992-11-19
- Stop
- 1992-11-19
The parties
- Patient
- patient Carylon Sharlene Reilly
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Humana
Record id
0f07fc79-9416-3271-d8c6-e476192b35b3