Claim total
$704.41
base $93.83 · payer covered $403.18
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-03-08
- Stop
- 2017-03-08
The parties
- Patient
- patient Debi Ortiz
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicare
Record id
0fd7f427-d82f-9324-cd59-94ad9fc23411