Claim total
$4,312.98
base $93.83 · payer covered $3,450.37
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-11-22
- Stop
- 2024-11-22
The parties
- Patient
- patient Loma Tawanna Ferry
- Provider
- provider Simon Tremblay
- Payer
- payer Medicare
Record id
04384da7-7311-e99a-d03b-a563458bad22