Claim total
$93.83
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2025-06-29
- Stop
- 2025-06-29
The parties
- Patient
- patient Eleonora Elfriede Johns
- Provider
- provider Kathern Krajcik
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer Medicaid
Record id
059d8239-ee62-6881-4c69-8fb1d56c49c3