Claim total
$775.00
base $93.83 · payer covered $775.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-10-07
- Stop
- 2019-10-07
The parties
- Patient
- patient Adrian Isaiah Durgan
- Provider
- provider Nikia Mills
- Payer
- payer Dual Eligible
Record id
046903bc-0773-63cf-e381-6dc1a85580a7