Claim total
$775.00
base $93.83 · payer covered $675.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2009-03-13
- Stop
- 2009-03-13
The parties
- Patient
- patient Flor Georgina Pollich
- Provider
- provider Robin Stokes
- Care site
- care site NEIGHBORHOOD HEALTHSOURCE
- Payer
- payer Medicaid
Record id
35733c37-83e7-4a67-4541-8064b29c751b