Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-02-18
- Stop
- 2015-02-18
The parties
- Patient
- patient Loyd Gail Olson
- Provider
- provider Lizeth Schiller
- Payer
- payer No insurance
Record id
2aad30ba-ae63-0b6b-1f87-5748809c6b5e