Claim total
$1,164.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1977-10-15
- Stop
- 1977-10-15
The parties
- Patient
- patient Lupe Isaiah Goyette
- Provider
- provider Robin Stokes
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer No insurance
Record id
0a09c8b4-1b33-f971-a4d2-722ab225dfb9