Claim total
$910.06
base $93.83 · payer covered $810.06
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-07-16
- Stop
- 2026-07-16
The parties
- Patient
- patient Cathryn Kandy Smith
- Provider
- provider Pearly Rohan
- Payer
- payer Medicaid
Record id
038ad96a-9908-2f0d-1236-2eb2f27cf83e