Claim total
$1,052.43
base $93.83 · payer covered $1,052.43
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2020-07-06
- Stop
- 2020-07-06
The parties
- Patient
- patient Coretta Philomena Boyle
- Provider
- provider Nikia Mills
- Payer
- payer Medicaid
Record id
06293262-0c72-c029-b0be-c9650bd78eb5