Claim total
$846.78
base $93.83 · payer covered $811.78
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1973-04-28
- Stop
- 1973-04-28
The parties
- Patient
- patient Gerardo Marvin Johns
- Provider
- provider Nikia Mills
- Payer
- payer Dual Eligible
Record id
01513b97-46a6-1303-6e93-60a63dfe0182