Claim total
$641.13
base $93.83 · payer covered $326.50
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-12-10
- Stop
- 2016-12-10
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-fbdd-bdb72f13bfa1