Claim total
$767.69
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2003-11-29
- Stop
- 2003-11-29
The parties
- Patient
- patient Bradford Bennie Klein
- Provider
- provider Julene Lemke
- Payer
- payer No insurance
Record id
01bbe7d1-151b-3eec-f0a5-3c94a6c1058f