Claim total
$641.13
base $93.83 · payer covered $512.90
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2009-10-06
- Stop
- 2009-10-06
The parties
- Patient
- patient Carolynn Georgeann Lesch
- Provider
- provider Lara O'Kon
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer Medicare
Record id
155337b4-7ad2-87d7-a96a-5e3a709b5a92