Claim total
$846.78
base $93.83 · payer covered $796.78
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1990-12-18
- Stop
- 1990-12-18
The parties
- Patient
- patient Beula Barrows
- Provider
- provider Nikia Mills
- Payer
- payer Medicaid
Record id
368b436b-071f-f268-0b4e-34043be9a051