Claim total
$704.41
base $93.83 · payer covered $604.41
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2024-07-15
- Stop
- 2024-07-15
The parties
- Patient
- patient Coretta Philomena Boyle
- Provider
- provider Nikia Mills
- Payer
- payer Medicaid
Record id
06293262-0c72-c029-482b-59d3775f0575