Claim total
$780.15
base $93.83 · payer covered $546.11
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2001-01-20
- Stop
- 2001-01-20
The parties
- Patient
- patient Luis Tressa Swaniawski
- Provider
- provider Kathern Krajcik
- Care site
- care site FAMILY LINK SOCIAL SERVICES
Record id
25155316-904c-da73-f009-e518c2b04b51