Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1973-06-15
- Stop
- 1973-06-15
The parties
- Patient
- patient Larita Candi Bashirian
- Provider
- provider Hank Orn
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer No insurance
Record id
1a69b1c3-11f2-231e-2fa5-20c38670d1d8