Claim total
$631.69
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-07-10
- Stop
- 2016-07-10
The parties
- Patient
- patient Denyse Fadel
- Provider
- provider Lizeth Schiller
- Payer
- payer Anthem
Record id
048ae427-86b6-6ce9-a036-a6e9a144a9d6