Claim total
$1,052.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-11-03
- Stop
- 2015-11-03
The parties
- Patient
- patient Stormy Tammera Schimmel
- Provider
- provider Robin Stokes
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer UnitedHealthcare
Record id
10c22f29-deea-9b07-a513-448261b1946d