Claim total
$910.06
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-09-14
- Stop
- 2021-09-14
The parties
- Patient
- patient Raymond Sonny Hirthe
- Provider
- provider Lara O'Kon
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer Cigna Health
Record id
120ef489-e49a-010f-220f-9f7ba3e907b5