Claim total
$1,115.71
base $93.83 · payer covered $892.56
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-10-04
- Stop
- 2023-10-04
The parties
- Patient
- patient Saul Little
- Provider
- provider Robby Gusikowski
- Care site
- care site Brooklyn Park Vet Center
- Payer
- payer Medicare
Record id
0205c336-938f-d85a-8086-8637dd1518de