Claim total
$977.42
base $93.83 · payer covered $977.42
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-10-01
- Stop
- 2018-10-01
The parties
- Patient
- patient Adrian Isaiah Durgan
- Provider
- provider Nikia Mills
- Payer
- payer Dual Eligible
Record id
046903bc-0773-63cf-239d-96a93f5ad37e