Claim total
$1,806.32
base $93.83 · payer covered $1,806.32
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-11-04
- Stop
- 2024-11-04
The parties
- Patient
- patient Adrian Isaiah Durgan
- Provider
- provider Nikia Mills
- Payer
- payer Dual Eligible
Record id
046903bc-0773-63cf-8dd0-bfb125fb658f