Claim total
$5,401.04
base $93.83 · payer covered $4,320.83
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-08-24
- Stop
- 2019-08-24
The parties
- Patient
- patient Porfirio West
- Provider
- provider Simon Tremblay
- Payer
- payer Medicare
Record id
05880a71-6004-727f-8fdb-bfef917f14bc