Claim total
$775.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2001-11-29
- Stop
- 2001-11-29
The parties
- Patient
- patient Ray Troy Osinski
- Provider
- provider Hank Orn
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer No insurance
Record id
1fd2fa7e-032c-24bf-aa24-e61391eef511