Claim total
$4,616.96
base $93.83 · payer covered $3,693.56
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1960-02-28
- Stop
- 1960-02-28
The parties
- Patient
- patient Claudie Angeles Von
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicare
Record id
23c8ce80-e14c-e470-b44f-8202abb821d1