Claim total
$775.00
base $93.83 · payer covered $446.89
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-09-06
- Stop
- 2026-09-06
The parties
- Patient
- patient Denyse Fadel
- Provider
- provider Lizeth Schiller
- Payer
- payer Medicare
Record id
048ae427-86b6-6ce9-030a-068318dd90f8