Claim total
$903.69
base $93.83 · payer covered $331.28
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-04-07
- Stop
- 2023-04-07
The parties
- Patient
- patient Agnus Jaskolski
- Provider
- provider Robin Stokes
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Humana
Record id
00bd0ed6-396a-5390-1b36-20292d28b933