Claim total
$1,373.45
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2010-07-07
- Stop
- 2010-07-07
The parties
- Patient
- patient Kelley Bradtke
- Provider
- provider Jared Berge
- Payer
- payer No insurance
Record id
2237710c-939d-74db-0a97-987a0e2cdf8b