Claim total
$1,473.19
base $93.83 · payer covered $992.92
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-04-12
- Stop
- 2025-04-12
The parties
- Patient
- patient Jeremy Gregory Jacobson
- Provider
- provider Nikia Mills
- Payer
- payer Medicare
Record id
04f9baea-0c64-12b2-614e-8b1c405717e3