Claim total
$1,041.77
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-07-30
- Stop
- 2012-07-30
The parties
- Patient
- patient Rosenda Wyman
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Humana
Record id
213e5519-4c28-300e-be6c-a67d52e7fc65