Claim total
$1,118.78
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1996-07-14
- Stop
- 1996-07-14
The parties
- Patient
- patient Weldon Normand Rohan
- Provider
- provider Anneliese Bradtke
- Payer
- payer No insurance
Record id
07811815-599c-8e38-e11e-30af17496319