Claim total
$843.43
base $93.83 · payer covered $693.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1973-12-05
- Stop
- 1973-12-05
The parties
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicaid
Record id
193e4bb3-7266-1ac6-a46e-38af492d6155