Claim total
$836.12
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2010-08-07
- Stop
- 2010-08-07
The parties
- Patient
- patient Ignacio Valentin Thiel
- Provider
- provider Robin Stokes
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Aetna
Record id
1a3239f1-ef20-fa58-7f17-6e38363aa543