Claim total
$985.80
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1967-04-17
- Stop
- 1967-04-17
The parties
- Patient
- patient Niesha Versie Medhurst
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Humana
Record id
368e2682-1863-e9f9-de9f-5afc587def53