Claim total
$840.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2007-05-02
- Stop
- 2007-05-02
The parties
- Patient
- patient Lenna Floretta Johns
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
Record id
19432449-afef-e532-9fc1-c1db2646d615