Claim total
$641.13
base $93.83 · payer covered $606.13
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1967-08-06
- Stop
- 1967-08-06
The parties
- Provider
- provider Nikia Mills
- Payer
- payer Dual Eligible
Record id
02b0534d-1cdc-7379-ab0d-55ac26677cb4