Claim total
$1,243.21
base $93.83 · payer covered $1,093.21
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1979-10-26
- Stop
- 1979-10-26
The parties
- Patient
- patient Vito Glenn Medhurst
- Provider
- provider Hank Orn
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicaid
Record id
26ddb759-380a-cffb-d61f-e0f0aeb78019