Claim total
$1,419.58
base $93.83 · payer covered $1,362.97
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2007-07-30
- Stop
- 2007-07-30
The parties
- Patient
- patient Adrian Isaiah Durgan
- Provider
- provider Nikia Mills
- Payer
- payer Medicaid
Record id
046903bc-0773-63cf-eb4f-0f24bb0d9fee