Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1984-08-30
- Stop
- 1984-08-30
The parties
- Patient
- patient Britany Kerrie West
- Provider
- provider Anneliese Bradtke
- Payer
- payer No insurance
Record id
02a95708-afbd-de6b-1fee-a9bb2cec22d3