Claim total
$505.13
base $93.83 · payer covered $405.13
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2022-01-03
- Stop
- 2022-01-03
The parties
- Patient
- patient Coretta Philomena Boyle
- Provider
- provider Nikia Mills
- Payer
- payer Medicaid
Record id
06293262-0c72-c029-cfda-4b475dd4e401