Claim total
$641.13
base $93.83 · payer covered $591.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1985-07-18
- Stop
- 1985-07-18
The parties
- Patient
- patient Cathryn Kandy Smith
- Provider
- provider Brandi Kessler
- Payer
- payer Medicaid
Record id
038ad96a-9908-2f0d-10f6-b51985b28484