Claim total
$772.84
base $93.83 · payer covered $722.84
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1989-05-12
- Stop
- 1989-05-12
The parties
- Patient
- patient Waltraud Lily Yundt
- Provider
- provider Robin Stokes
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicaid
Record id
1f58a428-477a-27c1-3c50-19a1660f5c82