Claim total
$1,253.14
base $93.83 · payer covered $1,253.14
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-01-01
- Stop
- 2019-01-01
The parties
- Patient
- patient Dione Ernser
- Provider
- provider Robin Stokes
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Dual Eligible
Record id
0bf6e6c4-0773-250a-aa8a-ac3390278f56