Claim total
$1,688.81
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2005-09-30
- Stop
- 2005-09-30
The parties
- Patient
- patient Loma Tawanna Ferry
- Provider
- provider Anneliese Bradtke
- Payer
- payer No insurance
Record id
04384da7-7311-e99a-cd96-fa646ed14043