Claim total
$1,658.72
base $93.83 · payer covered $1,658.72
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-04-16
- Stop
- 2021-04-16
The parties
- Patient
- patient Evelin Mozella Jones
- Provider
- provider Robin Stokes
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicaid
Record id
3b47c977-4eab-4cdd-60c0-3f887b2a5942