Claim total
$616.58
base $93.83 · payer covered $516.58
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2022-11-24
- Stop
- 2022-11-24
The parties
- Patient
- patient Terese Darla Williamson
- Provider
- provider Hank Orn
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicaid
Record id
0098424c-ec2c-0924-f17e-2d8c350d1f5c