Claim total
$775.00
base $93.83 · payer covered $484.35
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-01-09
- Stop
- 2021-01-09
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-bf6d-9d55822ff1e0