Claim total
$1,212.20
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-05-27
- Stop
- 2023-05-27
The parties
- Patient
- patient Jefferson Renaldo Dach
- Provider
- provider Robin Stokes
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer UnitedHealthcare
Record id
17cb5ccc-4c1f-9747-0e4f-4e58dca98495