Claim total
$767.69
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1988-09-03
- Stop
- 1988-09-03
The parties
- Patient
- patient Bradford Bennie Klein
- Provider
- provider Anneliese Bradtke
- Payer
- payer No insurance
Record id
01bbe7d1-151b-3eec-0dfd-93c64a566941