Claim total
$906.71
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2005-06-12
- Stop
- 2005-06-12
The parties
- Patient
- patient Denyse Fadel
- Provider
- provider Lizeth Schiller
- Payer
- payer No insurance
Record id
048ae427-86b6-6ce9-e32a-64d0fc6ffebb