Claim total
$1,104.44
base $93.83 · payer covered $1,104.44
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-04-15
- Stop
- 2024-04-15
The parties
- Patient
- patient Somer Olevia Turcotte
- Provider
- provider Jayme Rempel
- Care site
- care site LIFE LINE COMMUNITY HEALTHCARE
- Payer
- payer Dual Eligible
Record id
1d56f07d-5f1a-2dbf-3108-d75ec53f648a