Claim total
$679.52
base $93.83 · payer covered $679.52
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2018-06-03
- Stop
- 2018-06-03
The parties
- Patient
- patient Abdul Sammie Spencer
- Provider
- provider Nikia Mills
- Payer
- payer Medicaid
Record id
009b9fb1-8515-f33d-883b-c448768d8a7e