Claim total
$854.15
base $93.83 · payer covered $754.15
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-10-10
- Stop
- 2023-10-10
The parties
- Patient
- patient Peg Tresa Cummerata
- Provider
- provider Nikia Mills
- Payer
- payer Medicaid
Record id
04fb4e35-41c7-7592-34f0-516e4ac3d98b