Claim total
$710.78
base $93.83 · payer covered $568.62
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-01-31
- Stop
- 2026-01-31
The parties
- Patient
- patient Harland Carmine Herzog
- Provider
- provider Tomas Waelchi
- Care site
- care site Brooklyn Park Vet Center
- Payer
- payer Medicare
Record id
0302711f-bc3a-898e-3afb-be87740df5b5