Claim total
$641.13
base $93.83 · payer covered $541.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-06-07
- Stop
- 2017-06-07
The parties
- Patient
- patient Miles Auer
- Provider
- provider Lara O'Kon
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer Medicaid
Record id
02b37b89-9593-6a10-b6ca-e36d2640aabe