Claim total
$13,335.40
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1976-04-17
- Stop
- 1976-04-17
The parties
- Patient
- patient Harland Carmine Herzog
- Provider
- provider Fred Monahan
- Care site
- care site Brooklyn Park Vet Center
- Payer
- payer No insurance
Record id
0302711f-bc3a-898e-821e-9a2c3889b035