Claim total
$979.43
base $93.83 · payer covered $879.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-07-01
- Stop
- 2017-07-01
The parties
- Patient
- patient Susanne Jenna Hahn
- Provider
- provider Hank Orn
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicaid
Record id
0ba36fae-b9a3-10c0-185c-2260154d8c8c