Claim total
$775.00
base $93.83 · payer covered $619.99
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1998-02-03
- Stop
- 1998-02-03
The parties
- Patient
- patient Lucie Shayla Metz
- Provider
- provider Lara O'Kon
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer Medicare
Record id
0095f26f-6c35-6a9c-ba41-d2f2483a335a