Claim total
$293.11
base $93.83 · payer covered $193.11
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2018-04-07
- Stop
- 2018-04-07
The parties
- Patient
- patient Shalon Arnetta Bosco
- Provider
- provider Nikia Mills
- Payer
- payer Medicaid
Record id
03f768f4-038d-f7fd-bc1a-cb24d8962871