Claim total
$846.78
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-08-30
- Stop
- 2017-08-30
The parties
- Patient
- patient Saul Little
- Provider
- provider Fred Monahan
- Care site
- care site Brooklyn Park Vet Center
- Payer
- payer Humana
Record id
0205c336-938f-d85a-d6ea-b91467e3fd9b