Claim total
$979.43
base $93.83 · payer covered $879.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-05-19
- Stop
- 2018-05-19
The parties
- Patient
- patient Jesse Lucas Rowe
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicaid
Record id
16996bed-1187-99fd-4ae4-743e7a6bcc64