Claim total
$843.43
base $93.83 · payer covered $793.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1947-03-08
- Stop
- 1947-03-08
The parties
- Patient
- patient Lonnie Schroeder
- Provider
- provider Julene Lemke
- Payer
- payer Medicaid
Record id
30ee6aa0-fa33-9d82-4ffe-fdc472559059