Claim total
$846.78
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-04-14
- Stop
- 2023-04-14
The parties
- Patient
- patient Pierre Vincent Moore
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Humana
Record id
1ebd8c35-12de-073a-0235-be20809dc32a