Claim total
$1,190.78
base $93.83 · payer covered $952.62
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-09-16
- Stop
- 2026-09-16
The parties
- Patient
- patient Brenna Gricelda Lind
- Provider
- provider Sherwood Nicolas
- Payer
- payer Medicare
Record id
0291d14d-46f7-a76b-2620-b300a2fb72f2