Claim total
$1,142.76
base $93.83 · payer covered $727.80
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-10-19
- Stop
- 2015-10-19
The parties
- Patient
- patient Latrisha Simonne Kuhlman
- Provider
- provider Simon Tremblay
- Payer
- payer Medicare
Record id
0277738c-b3e3-4ada-d3f6-44df7f1ec884