Claim total
$840.41
base $93.83 · payer covered $840.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2011-03-29
- Stop
- 2011-03-29
The parties
- Patient
- patient Peg Tresa Cummerata
- Provider
- provider Nikia Mills
- Payer
- payer Medicaid
Record id
04fb4e35-41c7-7592-d1df-b59538bee05d