Claim total
$838.28
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-10-20
- Stop
- 2021-10-20
The parties
- Patient
- patient Sha Robin Reilly
- Provider
- provider Hank Orn
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer No insurance
Record id
043d6e13-0cc7-07f3-12d5-a44bf0532d66