Claim total
$767.69
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-09-16
- Stop
- 2025-09-17
The parties
- Provider
- provider Lara O'Kon
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer UnitedHealthcare
Record id
0177a0d4-f7b6-3393-e0b5-3c2fd1978358