Claim total
$1,802.03
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-07-24
- Stop
- 2014-07-24
The parties
- Patient
- patient Earline Madelaine Ratke
- Provider
- provider Hank Orn
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Humana
Record id
205cc105-0f5f-8891-badc-8a2a44f4f898