Claim total
$836.12
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1987-06-27
- Stop
- 1987-06-27
The parties
- Patient
- patient Marshall Ellis Bradtke
- Provider
- provider Ruben Farrell
- Payer
- payer No insurance
Record id
0cefa359-fd5a-c050-9d9b-07d8ae8609d4