Claim total
$1,074.87
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2005-06-24
- Stop
- 2005-06-24
The parties
- Patient
- patient Josiah Erich Willms
- Provider
- provider Lara O'Kon
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer No insurance
Record id
0ea6b0b3-7e8d-ccc7-83ff-03f47b083360