Claim total
$1,032.38
base $93.83 · payer covered $882.38
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1982-06-19
- Stop
- 1982-06-19
The parties
- Patient
- patient Gerardo Marvin Johns
- Provider
- provider Nikia Mills
- Payer
- payer Medicaid
Record id
01513b97-46a6-1303-f732-4c99b53bde2b