Claim total
$767.69
base $93.83 · payer covered $340.61
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-12-06
- Stop
- 2014-12-06
The parties
- Patient
- patient Amanda Kelsey Daugherty
- Provider
- provider Robin Stokes
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Anthem
Record id
00a2ce2f-1e05-ab20-a9d0-5868fdf1dac7