Claim total
$847.72
base $93.83 · payer covered $847.72
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-06-07
- Stop
- 2025-06-07
The parties
- Patient
- patient Belva Nadene Kuphal
- Provider
- provider Robin Stokes
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicaid
Record id
0430ce7c-cb64-da75-1ec8-a4fc699f7092