Claim total
$780.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1978-07-02
- Stop
- 1978-07-02
The parties
- Patient
- patient Denny Virgilio Kiehn
- Provider
- provider Lizeth Schiller
- Payer
- payer No insurance
Record id
128f92e2-3eba-387d-d9c5-2f1809e405d8