Claim total
$978.49
base $93.83 · payer covered $596.38
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2000-01-10
- Stop
- 2000-01-10
The parties
- Patient
- patient Dino Forrest Leuschke
- Provider
- provider Lara O'Kon
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer Medicare
Record id
2d2c8cd2-088a-6e99-abfa-8dd63a978f65