Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-08-30
- Stop
- 2022-08-31
The parties
- Provider
- provider Kathern Krajcik
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer UnitedHealthcare
Record id
0177a0d4-f7b6-3393-6745-956ac0c705b8