Claim total
$1,184.44
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1975-07-19
- Stop
- 1975-07-19
The parties
- Patient
- patient Bradford Bennie Klein
- Provider
- provider Anneliese Bradtke
- Payer
- payer No insurance
Record id
01bbe7d1-151b-3eec-4e76-89d6f11be5b6