Claim total
$704.41
base $93.83 · payer covered $377.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-12-09
- Stop
- 2024-12-09
The parties
- Patient
- patient Latrisha Simonne Kuhlman
- Provider
- provider Simon Tremblay
- Payer
- payer Medicare
Record id
0277738c-b3e3-4ada-bdef-38839aafb0b0