Claim total
$840.41
base $93.83 · payer covered $740.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-05-25
- Stop
- 2017-05-25
The parties
- Patient
- patient Cathryn Kandy Smith
- Provider
- provider Brandi Kessler
- Payer
- payer Medicaid
Record id
038ad96a-9908-2f0d-8121-f9068378122c