Claim total
$979.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-06-10
- Stop
- 2018-06-10
The parties
- Patient
- patient Grant Earl Fay
- Provider
- provider Lara O'Kon
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer Humana
Record id
1db3f28a-a567-c10e-16eb-74cda1b5e9e7