Claim total
$1,261.32
base $93.83 · payer covered $924.39
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-12-16
- Stop
- 2017-12-16
The parties
- Patient
- patient Harland Carmine Herzog
- Provider
- provider Fred Monahan
- Care site
- care site Brooklyn Park Vet Center
- Payer
- payer Medicare
Record id
0302711f-bc3a-898e-bc65-97d45bf5399e