Claim total
$505.13
base $93.83 · payer covered $404.10
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-12-28
- Stop
- 2019-12-28
The parties
- Patient
- patient Harland Carmine Herzog
- Provider
- provider Lashell Weber
- Care site
- care site Brooklyn Park Vet Center
- Payer
- payer Medicare
Record id
0302711f-bc3a-898e-be43-a5b5f14100b1