Claim total
$772.84
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-05-07
- Stop
- 2018-05-07
The parties
- Patient
- patient Zofia Shakira Wilkinson
- Provider
- provider Kathern Krajcik
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer Humana
Record id
20a24b42-e25a-2edc-5fbc-db30be848fdd