Claim total
$1,112.41
base $93.83 · payer covered $1,112.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-08-21
- Stop
- 2015-08-21
The parties
- Patient
- patient Colby Wunsch
- Provider
- provider Nikia Mills
- Payer
- payer Dual Eligible
Record id
02d10ce5-acf0-36ed-6e74-bad0d4b548c3