Claim total
$9,465.43
base $93.83 · payer covered $7,572.33
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-10-25
- Stop
- 2019-10-25
The parties
- Patient
- patient Loma Tawanna Ferry
- Provider
- provider Simon Tremblay
- Payer
- payer Medicare
Record id
04384da7-7311-e99a-b15f-f33324cc5f59