Claim total
$846.78
base $93.83 · payer covered $677.42
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-12-05
- Stop
- 2015-12-05
The parties
- Patient
- patient Harland Carmine Herzog
- Provider
- provider Lucas Kautzer
- Care site
- care site Brooklyn Park Vet Center
- Payer
- payer Medicare
Record id
0302711f-bc3a-898e-e252-8d1023d00586