Claim total
$1,457.08
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-09-30
- Stop
- 2017-09-30
The parties
- Patient
- patient Johnson Mark Eichmann
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
Record id
129d6e6d-9226-87d7-46f2-4fa9e129a5d0