Claim total
$917.37
base $93.83 · payer covered $733.89
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1997-01-28
- Stop
- 1997-01-28
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-ee49-2aa5000d9b08