Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1994-03-16
- Stop
- 1994-03-16
The parties
- Patient
- patient Jolyn Braun
- Provider
- provider Hank Orn
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer No insurance
Record id
1fc4994f-8a32-2b7e-f0f4-07fac7e45413