Claim total
$780.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-09-15
- Stop
- 2021-09-15
The parties
- Patient
- patient Jake Nolan Wisozk
- Provider
- provider Hank Orn
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Humana
Record id
201320b1-6cb6-72de-4404-bd1e36bf10a1