Claim total
$838.28
base $93.83 · payer covered $670.61
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-10-25
- Stop
- 2018-10-25
The parties
- Patient
- patient Lamar Mark Connelly
- Provider
- provider Simon Tremblay
- Payer
- payer Medicare
Record id
050746ba-be7e-c592-00de-642d23583e09