Claim total
$767.69
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1974-08-17
- Stop
- 1974-08-17
The parties
- Patient
- patient Jonathon Elroy Borer
- Provider
- provider Robin Stokes
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer No insurance
Record id
13917145-8746-415a-eaa9-48391c934800