Claim total
$1,273.98
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2005-12-10
- Stop
- 2005-12-10
The parties
- Patient
- patient Bradford Bennie Klein
- Provider
- provider Lowell Blick
- Payer
- payer No insurance
Record id
01bbe7d1-151b-3eec-6a44-096b9b27a7b3