Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1973-03-31
- Stop
- 1973-03-31
The parties
- Patient
- patient Harland Carmine Herzog
- Provider
- provider Aubrey Carroll
- Care site
- care site Brooklyn Park Vet Center
- Payer
- payer No insurance
Record id
0302711f-bc3a-898e-e1ef-f9e232f4df91