Claim total
$843.43
base $93.83 · payer covered $693.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2004-08-12
- Stop
- 2004-08-12
The parties
- Patient
- patient Cathryn Kandy Smith
- Provider
- provider Brandi Kessler
- Payer
- payer Medicaid
Record id
038ad96a-9908-2f0d-6f95-bdf0815ecf29