Claim total
$1,164.68
base $93.83 · payer covered $745.33
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1987-12-10
- Stop
- 1987-12-10
The parties
- Patient
- patient Ahmad Will Tremblay
- Provider
- provider Shani Carroll
- Payer
- payer Medicare
Record id
391ab23c-b263-c137-5b1b-47b7fef5fccf