Claim total
$1,115.43
base $93.83 · payer covered $1,065.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2004-12-29
- Stop
- 2004-12-29
The parties
- Patient
- patient Aaron Merle Schroeder
- Provider
- provider Nikia Mills
- Payer
- payer Medicaid
Record id
347e8a4e-5c81-360d-b689-ed2a749f7bcf