Claim total
$1,049.08
base $93.83 · payer covered $1,049.08
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1993-09-15
- Stop
- 1993-09-16
The parties
- Patient
- patient Susann Ayana Armstrong
- Provider
- provider Lara O'Kon
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer Humana
Record id
35733f82-dba4-4fce-3b61-05db8af89820