Claim total
$777.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2009-10-28
- Stop
- 2009-10-28
The parties
- Patient
- patient Jeramy Diego Keebler
- Provider
- provider Lara O'Kon
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer Humana
Record id
024ea619-fff0-c0e8-5f3e-a25fc0b9a6f9