Claim total
$1,052.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1996-01-16
- Stop
- 1996-01-16
The parties
- Patient
- patient Edie Victoria Zulauf
- Provider
- provider Hank Orn
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Humana
Record id
2fbaa88f-9da9-5871-442b-9bd42ca1c51a