Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1994-09-05
- Stop
- 1994-09-05
The parties
- Patient
- patient Sandy Salvador Will
- Provider
- provider Robin Stokes
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer No insurance
Record id
05317da0-053c-0c68-e673-a52b26ef5a52