Claim total
$1,553.42
base $93.83 · payer covered $1,453.42
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-11-27
- Stop
- 2022-11-27
The parties
- Patient
- patient Faustino Romeo Bauch
- Provider
- provider Hank Orn
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicaid
Record id
03e24eff-3793-eaeb-617a-f9526fa7c6d6