Claim total
$775.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1982-04-30
- Stop
- 1982-04-30
The parties
- Patient
- patient Justine Walter Sanford
- Provider
- provider Anneliese Bradtke
- Payer
- payer UnitedHealthcare
Record id
22af1154-23c4-5080-fb98-63c230cab7e7