Claim total
$846.78
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1990-07-14
- Stop
- 1990-07-14
The parties
- Patient
- patient Amanda Kelsey Daugherty
- Provider
- provider Robin Stokes
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer No insurance
Record id
00a2ce2f-1e05-ab20-f716-cbe91ccd0a3d