Claim total
$830.97
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1990-09-15
- Stop
- 1990-09-15
The parties
- Patient
- patient Bradford Bennie Klein
- Provider
- provider Lowell Blick
- Payer
- payer No insurance
Record id
01bbe7d1-151b-3eec-75bb-be013f0a3b6f