Claim total
$711.72
base $93.83 · payer covered $351.83
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-01-15
- Stop
- 2022-01-15
The parties
- Patient
- patient Amanda Kelsey Daugherty
- Provider
- provider Robin Stokes
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Anthem
Record id
00a2ce2f-1e05-ab20-8c06-8b742e21a936