Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-09-28
- Stop
- 2022-09-28
The parties
- Patient
- patient Saul Little
- Provider
- provider Robby Gusikowski
- Care site
- care site Brooklyn Park Vet Center
- Payer
- payer Humana
Record id
0205c336-938f-d85a-129d-1120bb85245f