Claim total
$772.84
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1984-08-18
- Stop
- 1984-08-18
The parties
- Patient
- patient Clara O'Conner
- Provider
- provider Kathern Krajcik
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer No insurance
Record id
0f6ac757-f138-648f-0afe-86e09a528527