Claim total
$978.56
base $93.83 · payer covered $928.56
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1990-02-16
- Stop
- 1990-02-16
The parties
- Patient
- patient Flor Georgina Pollich
- Provider
- provider Robin Stokes
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicaid
Record id
35733c37-83e7-4a67-4402-737e1830d088