Claim total
$1,722.00
base $93.83 · payer covered $1,722.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-04-15
- Stop
- 2014-04-15
The parties
- Patient
- patient Augustine Tromp
- Provider
- provider Nikia Mills
- Payer
- payer Medicaid
Record id
06d2c16f-b04d-02ef-8003-c309bdf95aad