Claim total
$767.69
base $93.83 · payer covered $767.69
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-03-26
- Stop
- 2021-03-26
The parties
- Patient
- patient Bruce Oscar Rath
- Provider
- provider Kathern Krajcik
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer Medicaid
Record id
38d7b5e6-2762-29d7-01cc-3bf0015ab718