Claim total
$293.11
base $93.83 · payer covered $193.11
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2022-12-08
- Stop
- 2022-12-08
The parties
- Patient
- patient Bettyann Wen Howell
- Provider
- provider Kathern Krajcik
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer Medicaid
Record id
0257a216-88a6-e7f3-b9e8-42f206b8d6d5