Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-08-21
- Stop
- 2014-08-21
The parties
- Patient
- patient Britany Kerrie West
- Provider
- provider Anneliese Bradtke
- Payer
- payer No insurance
Record id
02a95708-afbd-de6b-3dde-6af238df292e