Claim total
$846.78
base $93.83 · payer covered $696.78
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2005-03-22
- Stop
- 2005-03-22
The parties
- Patient
- patient Peg Tresa Cummerata
- Provider
- provider Nikia Mills
- Payer
- payer Medicaid
Record id
04fb4e35-41c7-7592-b8fe-7c2edb6befc9