Claim total
$1,443.56
base $93.83 · payer covered $1,154.84
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-04-18
- Stop
- 2025-04-19
The parties
- Patient
- patient Kirstin Caryn Waelchi
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicare
Record id
36334c94-5ccd-5bbe-805e-95e133771694