Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1987-12-08
- Stop
- 1987-12-08
The parties
- Patient
- patient Lucie Shayla Metz
- Provider
- provider Kathern Krajcik
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer No insurance
Record id
0095f26f-6c35-6a9c-fcba-ec5a4abddf8f