Claim total
$979.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2002-06-04
- Stop
- 2002-06-04
The parties
- Patient
- patient Donte Adrian Okuneva
- Provider
- provider Robin Stokes
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer No insurance
Record id
2eba3a71-a8e8-b211-04f5-fdfa90654d9a