Claim total
$846.78
base $93.83 · payer covered $746.78
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2016-02-21
- Stop
- 2016-02-21
The parties
- Patient
- patient Lanny Hilll
- Provider
- provider Lara O'Kon
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer Medicaid
Record id
323785c4-e239-b467-4a6a-5c2e44afc126