Claim total
$767.69
base $93.83 · payer covered $617.69
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1999-01-19
- Stop
- 1999-01-19
The parties
- Patient
- patient Augustine Tromp
- Provider
- provider Nikia Mills
- Payer
- payer Medicaid
Record id
06d2c16f-b04d-02ef-3655-6aa3fbe110a9