Claim total
$772.84
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2003-03-08
- Stop
- 2003-03-09
The parties
- Patient
- patient Ardell Balistreri
- Provider
- provider Hank Orn
- Care site
- care site WEST METRO WELLNESS PC
Record id
225082dc-9ef3-4a84-6479-b8e0e761024d