Claim total
$843.43
base $93.83 · payer covered $693.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1956-08-13
- Stop
- 1956-08-13
The parties
- Patient
- patient Zachery Keenan Berge
- Provider
- provider Robin Stokes
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicaid
Record id
29247b3f-f26a-3ab7-13c8-8340463ed51e