Claim total
$704.41
base $93.83 · payer covered $604.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-05-24
- Stop
- 2022-05-24
The parties
- Provider
- provider Lara O'Kon
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer Medicaid
Record id
0f8011da-3f5b-ae5a-376a-2f74be24ced3