Claim total
$777.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2005-06-19
- Stop
- 2005-06-19
The parties
- Patient
- patient Terrance Derek Mueller
- Provider
- provider Anneliese Bradtke
- Payer
- payer No insurance
Record id
032e5f12-51a3-9303-3057-e39594e78469