Claim total
$911.00
base $93.83 · payer covered $911.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-01-21
- Stop
- 2012-01-21
The parties
- Patient
- patient Clara O'Conner
- Provider
- provider Kathern Krajcik
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer Aetna
Record id
0f6ac757-f138-648f-6ef7-b69d642ab762