Claim total
$1,428.11
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2003-12-27
- Stop
- 2003-12-27
The parties
- Patient
- patient Margarita Isabela Palomo
- Provider
- provider Nikia Mills
- Payer
- payer No insurance
Record id
13e5b780-184a-497a-5607-f3498b91616b