Claim total
$1,597.60
base $93.83 · payer covered $1,597.60
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-06-23
- Stop
- 2022-06-23
The parties
- Patient
- patient Cathryn Kandy Smith
- Provider
- provider Pearly Rohan
- Payer
- payer Medicaid
Record id
038ad96a-9908-2f0d-0f48-1fe1fc7557ed