Claim total
$1,007.32
base $93.83 · payer covered $805.85
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-12-22
- Stop
- 2018-12-22
The parties
- Patient
- patient Harland Carmine Herzog
- Provider
- provider Robby Gusikowski
- Care site
- care site Brooklyn Park Vet Center
- Payer
- payer Medicare
Record id
0302711f-bc3a-898e-7705-3586234346bd