Claim total
$1,463.73
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2004-08-16
- Stop
- 2004-08-16
The parties
- Patient
- patient Latrisha Simonne Kuhlman
- Provider
- provider Anneliese Bradtke
- Payer
- payer No insurance
Record id
0277738c-b3e3-4ada-94d9-3862b5ce6984