Claim total
$767.69
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-03-28
- Stop
- 2020-03-28
The parties
- Patient
- patient Jeremy Gregory Jacobson
- Provider
- provider Nikia Mills
Record id
04f9baea-0c64-12b2-a01e-569c9d41fbc8