Claim total
$775.00
base $93.83 · payer covered $465.01
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-11-18
- Stop
- 2019-11-18
The parties
- Patient
- patient Bo Gino Murazik
- Provider
- provider Hank Orn
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Humana
Record id
003af57f-1886-144b-475c-cf637355ad03