Claim total
$910.06
base $93.83 · payer covered $810.06
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-08-11
- Stop
- 2026-08-11
The parties
- Patient
- patient Milagros Lynetta Mertz
- Provider
- provider Nikia Mills
- Payer
- payer Medicaid
Record id
1102b012-744a-4940-1e16-b8a5c525e8c4