Claim total
$775.00
base $93.83 · payer covered $619.99
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-04-11
- Stop
- 2024-04-11
The parties
- Patient
- patient Minnie Glenna Hilpert
- Provider
- provider Simon Tremblay
- Payer
- payer Medicare
Record id
164073e3-ecac-90a2-46b3-cfc3d4572f07