Claim total
$850.74
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1979-09-03
- Stop
- 1979-09-03
The parties
- Patient
- patient Garland Thiel
- Provider
- provider Lizeth Schiller
- Payer
- payer No insurance
Record id
02ec371b-21cc-5c35-4353-78c0ab412ff6