Claim total
$843.43
base $93.83 · payer covered $743.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-04-06
- Stop
- 2020-04-06
The parties
- Patient
- patient Zenia Tegan Nolan
- Provider
- provider Lara O'Kon
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer Medicaid
Record id
0f1bcaa4-de3d-14e5-d48c-ba72c627f5f7