Claim total
$767.69
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1978-08-12
- Stop
- 1978-08-12
The parties
- Patient
- patient Raven Julieta Johnson
- Provider
- provider Nikia Mills
- Payer
- payer No insurance
Record id
1c0fdca8-d5a1-2af7-a8b3-a2e711c1e35d