Claim total
$780.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1980-01-18
- Stop
- 1980-01-18
The parties
- Patient
- patient Ardith Anette Langosh
- Provider
- provider Nikia Mills
- Payer
- payer No insurance
Record id
19d11b13-231e-035e-01ba-3eff94e75ae3