Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2013-08-07
- Stop
- 2013-08-07
The parties
- Patient
- patient Saul Little
- Provider
- provider Tomas Waelchi
- Care site
- care site Brooklyn Park Vet Center
- Payer
- payer Humana
Record id
0205c336-938f-d85a-456f-21180dc86de4