Claim total
$229.83
base $93.83 · payer covered $229.83
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2022-02-27
- Stop
- 2022-02-27
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-e862-7f27c4db8cfe