Claim total
$986.51
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1990-01-03
- Stop
- 1990-01-03
The parties
- Patient
- patient Carl Brooke Dietrich
- Provider
- provider Lizeth Schiller
- Payer
- payer No insurance
Record id
2ce0ad34-3115-7435-fa24-a0441b68410c