Claim total
$1,093.21
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2004-06-08
- Stop
- 2004-06-08
The parties
- Patient
- patient Selene Dona Okuneva
- Provider
- provider Robin Stokes
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer No insurance
Record id
1922bd27-5aa8-1926-6f16-27f28a9be09a