Claim total
$780.15
base $93.83 · payer covered $780.15
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-03-08
- Stop
- 2026-03-08
The parties
- Patient
- patient Sherron Mohr
- Provider
- provider Samuel Boyle
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer Medicaid
Record id
0ceab98b-52e7-ab40-7aa2-43cfe943925b