Claim total
$641.13
base $93.83 · payer covered $591.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1988-09-16
- Stop
- 1988-09-16
The parties
- Patient
- patient Wilson Teodoro Kihn
- Provider
- provider Hank Orn
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicaid
Record id
04540647-5ff4-de4a-ba8c-82ad9f851fa6