Claim total
$3,964.02
base $93.83 · payer covered $3,171.20
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-11-17
- Stop
- 2023-11-17
The parties
- Patient
- patient Loma Tawanna Ferry
- Provider
- provider Simon Tremblay
- Payer
- payer Medicare
Record id
04384da7-7311-e99a-878f-772bd54fa46c