Claim total
$767.69
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1965-10-06
- Stop
- 1965-10-06
The parties
- Provider
- provider Nikia Mills
- Payer
- payer No insurance
Record id
2c592f19-912d-3aa0-e0ea-f9cc2c8fc2af