Claim total
$1,123.02
base $93.83 · payer covered $715.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2003-04-14
- Stop
- 2003-04-14
The parties
- Patient
- patient Emelda Buckridge
- Provider
- provider Hank Orn
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicare
Record id
0d3f842e-991a-78cb-fe42-f5b6203e9b8f