Claim total
$1,199.49
base $93.83 · payer covered $959.58
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-01-02
- Stop
- 2021-01-02
The parties
- Patient
- patient Harland Carmine Herzog
- Provider
- provider Fred Monahan
- Care site
- care site Brooklyn Park Vet Center
- Payer
- payer Medicare
Record id
0302711f-bc3a-898e-6b0b-63128ba93640