Claim total
$641.13
base $93.83 · payer covered $541.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2009-06-30
- Stop
- 2009-06-30
The parties
- Patient
- patient Leigh Weston Lubowitz
- Provider
- provider Robin Stokes
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicaid
Record id
0031d341-6ceb-7483-84b2-c68d926452bc