Claim total
$910.06
base $93.83 · payer covered $760.06
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1983-07-07
- Stop
- 1983-07-07
The parties
- Patient
- patient Cathryn Kandy Smith
- Provider
- provider Pearly Rohan
- Payer
- payer Medicaid
Record id
038ad96a-9908-2f0d-89db-8cbe98280102