Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1982-07-31
- Stop
- 1982-07-31
The parties
- Patient
- patient Bradford Bennie Klein
- Provider
- provider Lowell Blick
- Payer
- payer No insurance
Record id
01bbe7d1-151b-3eec-2d05-3948e5640fa4