Claim total
$704.41
base $93.83 · payer covered $704.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-08-05
- Stop
- 2021-08-05
The parties
- Patient
- patient Tamica Sarita Robel
- Provider
- provider Hank Orn
- Care site
- care site WEST METRO WELLNESS PC
Record id
03563bad-3832-f030-87a2-a49c65d513e4