Claim total
$4,106.39
base $93.83 · payer covered $3,285.10
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-09-27
- Stop
- 2025-09-27
The parties
- Patient
- patient Porfirio West
- Provider
- provider Simon Tremblay
- Payer
- payer Medicare
Record id
05880a71-6004-727f-7673-caa321202515