Claim total
$641.13
base $93.83 · payer covered $491.13
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1987-07-04
- Stop
- 1987-07-04
The parties
- Patient
- patient Susanne Jenna Hahn
- Provider
- provider Hank Orn
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicaid
Record id
0ba36fae-b9a3-10c0-e15f-c46184d87846