Claim total
$631.69
base $93.83 · payer covered $505.34
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1988-12-13
- Stop
- 1988-12-13
The parties
- Patient
- patient Lucie Shayla Metz
- Provider
- provider Kathern Krajcik
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer Medicare
Record id
0095f26f-6c35-6a9c-aa62-bbc8617f7f93