Claim total
$1,285.53
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1987-02-16
- Stop
- 1987-02-16
The parties
- Provider
- provider Latia Lemke
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer No insurance
Record id
3b110507-6544-1ce0-5942-9efa2c3a61cf