Claim total
$1,485.92
base $93.83 · payer covered $1,188.73
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1990-12-25
- Stop
- 1990-12-25
The parties
- Patient
- patient Lucie Shayla Metz
- Provider
- provider Kathern Krajcik
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer Medicare
Record id
0095f26f-6c35-6a9c-baf0-8f135dbdcfc5