Claim total
$1,646.35
base $93.83 · payer covered $153.01
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-11-26
- Stop
- 2016-11-26
The parties
- Patient
- patient Otelia Kelsi Grant
- Provider
- provider Hank Orn
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer UnitedHealthcare
Record id
11a50515-48c1-9cb9-bdb8-8f865dda9924