Claim total
$639.00
base $93.83 · payer covered $639.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-09-25
- Stop
- 2017-09-25
The parties
- Patient
- patient Adrian Isaiah Durgan
- Provider
- provider Nikia Mills
- Payer
- payer Dual Eligible
Record id
046903bc-0773-63cf-e5c3-8b1a8b102243