Claim total
$843.43
base $93.83 · payer covered $843.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-04-18
- Stop
- 2025-04-18
The parties
- Patient
- patient Jamal Antony Barrows
- Provider
- provider Lara O'Kon
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer Medicaid
Record id
27d80141-fbf3-b01e-3b05-40bf0b373fb8