Claim total
$910.06
base $93.83 · payer covered $728.04
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-12-04
- Stop
- 2023-12-04
The parties
- Patient
- patient Latrisha Simonne Kuhlman
- Provider
- provider Simon Tremblay
- Payer
- payer Medicare
Record id
0277738c-b3e3-4ada-eec4-fc29c8513843