Claim total
$1,119.67
base $93.83 · payer covered $1,119.67
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1982-10-10
- Stop
- 1982-10-10
The parties
- Patient
- patient Sueann Zemlak
- Provider
- provider Hank Orn
- Care site
- care site WEST METRO WELLNESS PC
Record id
17e8982e-72b3-b77d-a343-edc1a5b87347