Claim total
$1,479.61
base $93.83 · payer covered $1,329.61
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1989-08-07
- Stop
- 1989-08-07
The parties
- Patient
- patient Belva Sau Barrows
- Provider
- provider Lara O'Kon
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer Medicaid
Record id
1625e802-c261-3bac-f1d9-5cd4aacd82e2