Claim total
$1,183.09
base $93.83 · payer covered $946.46
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-01-20
- Stop
- 2024-01-20
The parties
- Patient
- patient Harland Carmine Herzog
- Provider
- provider Aubrey Carroll
- Care site
- care site Brooklyn Park Vet Center
- Payer
- payer Medicare
Record id
0302711f-bc3a-898e-5b0f-8c604155ba9e